核素扫描、CT、MRI确定骨转移肿瘤区的作用比较

目的 比较核素扫描、CT、MRI界定骨转移肿瘤区的价值。方法 16例骨转移瘤中包括肺癌5例、乳腺癌3例、直肠癌3例、肝癌1例、原发灶不明4例。CT、MRI与核素骨扫描的间隔时间少于14d。结果 50个骨转移灶或经局部放疗后疼痛缓解或消失,或经病理、或经随访证实。47个病灶MRI阳性,44个部位骨扫描呈阳性表现(5个部位证实为假阳性),29个病灶CT表现阳性。MRI界定的22个病灶范围大于CT,6个病灶显示较CT明确,21个病灶二者相当。结论 MRI确定骨转移肿瘤区的价值大于CT,因此在做骨转移瘤放射治疗方案时,最好参考MRI。

Comparison of the value of radionuclide bone scan,CT and MRI on the determination of bone metastatic tumor volume

Objective To compare the value of radionuelide bone scan, CT and MRI on the determination of bone metastatic tumor volume, and confirm the value of MRI. Methods The 16 patients with metastatic bone tumor were enrolled, which included 5 cases of lung cancer, 3 cases of breasl cancer, 3 cases of rectal cancer, 1 case of liver cancer, 4 cases of uncertained primary malignant disease. Interval between CT, MRI and radionuclide bone scan were shorter than 14 days. Results The 50 metaslatic sites were verified through such methods as relief of pain after local irradiation, or biopsy, or follow-up. When checked with MRI, 47 of 50 sites showed positiveness. When checked with bone scan, 44 sites showed positiveness, in which 5 sites were confirmed not to be metastatic tumor; 29 metastatic sites were found with CT. The volume of 22 metastatic tumor determinated with MRI was bigger than that with CT. The boundary of 6 sites was ambiguous when checked with CT, but definitive when checked with MRI. The volume of 21 sites detected by MRI was equal to that detected by CT. Conclusion MRI is more sensitive than radionuclide bone scan and CT in assessing the extent of metastatic tumor, it is necessary to refer to MR imaging when making radiation treatment plan.