MRI、CT诊断脊椎转移瘤的比较分析

目的:探讨脊椎转移瘤的MRI及CT征象,以提高脊椎转移瘤的早期诊断率。方法:对138例脊椎转移瘤患者进行MRI与CT检查,比较脊椎转移瘤在MRI和CT上的表现。结果:138例脊椎转移瘤共发现399个椎体异常,237处椎管受累,190处椎旁软组织肿块,178处病理性骨折。MRI表现为T1加权低信号74%(294/399);T2加权表现为高信号62%(249/399);脂肪抑制T2加权表现为高信号86%(344/399)。CT检出273处病灶表现为不同形态的骨质破坏,溶骨型66%(179/273),成骨型24%(65/273),混合型10%(29/273)。结论:MRI的敏感性和特异性高于CT,MRI和CT联合应用可提高脊椎转移瘤诊断的敏感性和准确性。

The comparative analysis of MRI and CT in diagnosis of spinal metastases

Objective:To explore of conventional MRI and CT in the diagnosis of spinal metastases.Methods:MRI and CT were performed in 138 patients with spine metastases.The detectability for vertebral metastasis was compared between the two modalities.Results:There were destructions of vertebral bodies in 399 lesions,spinal canal involvement in 237 lesions,paravertebral soft tissue masses in 190 lesions and pathological fractures of vertebral bodies in 178 lesions.MRI of 399 vertebral bodies demonstrated decreased signal intensity(74%,294/399) on T_1WI,and increased signal intensity(62%,249/399) on T_2WI.CT showed bone destruction of vertebral bodies in 273 lesions.The invasion of vertebra could be divided into 3 types:osteolytic(66%,179/273),osteoblastic(24%,65/273) and mixed type(10%,29/273).Conclusion:The sensitivity and specificity of MRI is higher than that of CT.MRI combined with CT can improve the sensitivity and accuracy in the diagnosis of spinal metastases.