儿童恶性肿瘤股骨转移的骨显像和MRI比较

目的比较骨显像和MRI在儿童恶性肿瘤股骨转移中的应用价值.方法对经病理检查确诊的25例恶性肿瘤患儿（神经母细胞瘤12例,淋巴瘤8例,原始神经外胚层肿瘤2例,横纹肌肉瘤3例）分别行全身骨显像和双侧股骨MRI,MRI采用自旋回波T1WI及短时反转恢复（STIR）序列冠状面成像.结果12例神经母细胞瘤患儿中骨显像阳性7例,可疑2例,阴性3例,7例阳性、2例可疑及1例阴性病例MRI检查均阳性;8例淋巴瘤骨显像阳性5例,阴性3例,5例阳性及2例阴性患儿MRI阳性;2例原始神经外胚层肿瘤骨显像与MRI均阳性;3例横纹肌肉瘤骨显像阳性2例,阴性1例,MRI均阳性.此外,MRI发现股骨的异常信号范围大于骨显像.结论在儿童恶性肿瘤骨转移中联合应用骨显像和MRI有助于尽早诊断及提高诊断准确性.

The comparative study of bone imaging and MRI on femoral bone metastases in children

Objective To compare the application of hone imaging and MRI in the detection of femoral infiltration of children's malignant tumors.Methods Whole body bone imaging and femoral MRI examination were performed for twenty-five patients with histologically confirmed femoral bone metastases in- cluding 12 neuroblastomas,8 lymphomas,2 primitive neuroectodermal tumors(PNETs)and 3 rhabdomyo- sarcoma.In MRI T_1-weighted and short tau inversion recovery(STIR)sequences coronal planes were recon- structed.Results In 12 neuroblastomas bone imaging showed 7 positive,2 equivocal,3 negative.Except 2 negative bone imaging cases all 10 patients presented positive on MRI.Among 8 lymphomas,5 were posi- tive and 1 was negative on both bone imaging and MRI,the other 2 were negative on bone imaging but posi- tive on MRI.Two PNETs presented positive on both bone imaging and MRI.Three rhabdomyosarcoma showed 2 positive and 1 negative on bone imaging,whereas both positive on MRI.The lesions detected by MRI were larger than those found by bone imaging.Conclusions Although MRI is more sensitive than bone imaging in the detection of femoral bone metastases in children;it is hard to find some skeletal lesions. Therefore,combined application of bone imaging with MRI may be helpful for the early and accurate diagno- ses for some patients.