肺癌椎体转移的磁共振成像表现对患者预后评价

目的评价磁共振成像(MRI)技术在肺癌椎体转移诊断中的作用,研究肺癌转移灶的病理征象能否预测患者的预后。方法收集病理及临床证实的肺癌椎体转移患者60例(椎体病灶病理活检证实20例,核素扫描及临床证实40例),60例患者病理均证实有原发肺腺癌,行脊柱MR扫描。均采用常规自旋回波(SE)T1WI、脂肪抑制序列(SPIR)序列、增强T1WI行矢状及横断面扫描。结果60例肺腺癌患者,MRI下均可见椎体信号异常。单发灶与多发灶组在椎体转移灶出现后患者的生存时间差异有统计学意义(t=10·63,P<0·01);无椎体附件受累与有椎体附件受累组间的患者生存时间差异有统计学意义(t=12·23,P<0·01);无椎旁软组织肿块与有椎旁软组织肿块组间的患者生存时间差异有统计学意义(t=12·50,P<0·01);无脊髓受压与有脊髓受压组间的患者生存时间差异有统计学意义(t=14·36,P<0·01)。结论MRI能够显示肺癌椎体转移的病理改变,MRI表现可以前瞻性地预测肺癌患者的病程。

Forecasting prognosis of patients with metastasis in the spine with MRI

Objective To assess the role of MRI on metastasis in the spine.To study whether the pathologic sign of metastatic focus could prognosticate the prognosis of patients with metastasis in the spine.Methods Sixty patients,who had biopsy-proven lung cancer and MRI examination of spine entered the study.Survival time after metastatic focus to spine in every patient was calculated.Results There were significant difference in the survival time after metastatic focus was diagnosed between patients with solitary focus and patients with multiple focus(t=10.63,P<0.01).There were significant difference in the survival time between patients with involvement of the pedicle without involvement of the pedicle(t=12.23,P<0.01),which is the same as patients with paraspinal mass and patients without paraspinal mass(t=12.50,P<0.01),and patients with spinal compression and patients without spinal compression(t=14.36,P<0.01).Conclusion MRI can provide imaging basis in diagnosing metastasis.As a marker of disease progression,MRI of spine can reflect prognosis of the primary neoplasm.