1047例骨转移瘤的影像学诊断

目的：分析１０４７例骨转移瘤Ｘ线、放射计算机体层摄影（ＥＣＴ）、ＣＴ及ＭＲＩ表现，并比较其敏感性及特异性。材料和方法：原发肿瘤主要为肺癌（２８．７５％），乳腺癌（１２．０３％）及鼻咽癌（５．０６％）等，２７．０３％来源不明。Ｘ线诊断９８８例，ＥＣＴ检查１２６例，ＣＴ扫描９７例，ＭＲＩ扫描４７例。结果：Ｘ线显示骨转移部位为脊椎、肋骨、四肢近段及颅骨。ＥＣＴ表现多骨多处浓集灶（８２．５４％）或单发浓集灶（１６．６７％），仅１例表现为稀疏病灶。ＭＲＩＴ１ＷＩ表现低信号（８０．８５％）或其他异常信号（１９．１５％）；Ｔ２ＷＩ呈高信号（６８．８５％）或其他异常信号（３１．１５％）。结论：ＭＲＩ及ＥＣＴ敏感性高于ＣＴ和Ｘ线。ＭＲＩ、ＣＴ及Ｘ线特异性高于ＥＣＴ。骨转移瘤首选ＥＣＴ并结合Ｘ线检查，必要时做ＣＴ或（和）ＭＲＩ检查。

Imaging diagnosis of bone metastases (analysis of 1 047 cases)

Purpose:To analyse and compare the fingings, sensitivity and specificity of conventional radiography, ECT, CT and MRI in the diagnosis of 1 047 cases with bone metastases. Materials and methods: The most common sources of skeletal metastases were carcinomas of the lung (28.75%), breast (12.03%), nasopharynx (5.06%) and unknown origin (27.03%). The plain films revealed 988 cases of bone metastases. 126 cases underwent ECT and 97 cases CT examination, 47 cases were examined by MRI. Results:The most commonly involved bones were the spine, ribs and pelvis on the plain films. ECT manifested multiple abnormal foci of increased radionuclide activity (82.54%), single focus (16.67%), and one case of photopenic metastasis. MRI demonstrated decreased signal intensity (80.85%) and other abnormal signal intensity (19.15%) on T 1WI and increased signal intensity (68.85%) and other abnormal signal intensity (31.15%) on T 2WI. The sensitivity of MRI and ECT was significantly higher than that of CT and X ray. However, the specificity of MRI, CT and X ray were significantly higher than that of ECT. Conclusion:ECT in combination with conventional radiograph should be the initial imaging modalities for bone metastases supplemented if necessary by CT or MRI.