核素骨显像诊断肿瘤骨转移的临床价值

目的探讨肿瘤骨转移的特点、比例以及核素骨显像对肿瘤骨转移的诊断价值。方法总结902例肿瘤患者(Ⅰ组)和96例无肿瘤史伴不明原因骨痛患者(Ⅱ组)的全身核素骨显像特征,统计骨转移所占的比例和转移特点。结果Ⅰ组:在902例患者中,未发现肿瘤骨转移的患者为579例,可疑患者97例,明确肿瘤骨转移的患者为226例(共987人次),其中全身各处肿瘤骨转移由高到低分别为16.0%(158/987),15.3%(151/987),15.2%(150/987),12.7%(125/987),8.4%(83/987),7.9%(78/987),7.3%(72/987),7.2%(71/987),4.6%(46/987),3.9%(38/987),0.9%(9/987),0.6%(6/987)。发现转移病灶个数分别为375、585、471、309、165、117、116、95、73、76、12、7,共计2401个转移灶。Ⅱ组:96例患者中,31例排除肿瘤骨转移,28例诊断为肿瘤骨转移,37例仍为可疑病例。结论放射性核素骨显像是一种灵敏度高的常规检查方法,对肿瘤骨转移的早期诊断有重要的价值。

Clinical value of skeletal scintigraphy in diagnosis of skeletal metastases in patients with carcinoma

Objective To evaluate the characteristics and distrubution of bone metastases in patients with malignant tumors by using skeletal scintigraphy.Methods Nine hundredand two patients with malignant tumors(group Ⅰ)and ninety-six patients with bone pain with unknowing reasons(group Ⅱ)were included in this study.Bone scan was underwent in every patient.Results In group Ⅰ,there were 579 patients with no bone metastases and 97 suspected cases,226 patients were with skeletal metastases(987 person-time totally).The parts of tumor metastasis were pelvis 16.0%(158/987,375nidi),ribs 15.3%(151/987,585 nidi),vertebra thoracalis 15.2%(150/987,471 nidi),lumbar vertebra 12.7%(125/987,309 nidi),femora 8.4%(83/987,165 nidi),articulatio humeri 7.9%(78/987,117 nidi),cervical vertebra 7.3%(72/987,116 nidi),sternum 7.2%(71/987,95 nidi),harnpan 4.6%(46/987,73 nidi),humeri 3.9%(38/987,76 nidi),tibiofibula 0.9%(9/987,12 nidi),ulna and oar 0.6%(6/987,7 nidi).In group Ⅱ,there were 31 patients with no bone metastases and 37 suspected cases,28 patients with skeletal metastases were diagnosed.Conclusion Bone scan is a sensitive,convenient and cost effective method to detect bone metastases in patients with carcinoma.