MRI与核素骨显像对脊柱转移瘤诊断价值的对比观察

目的比较MRI与核素骨显像对诊断脊柱转移瘤的价值.方法对48例同时进行了MRI和核素骨显像并确诊为脊柱转移瘤的病例,以MRI扫描野内脊柱为观察目标,人为地将脊柱分为颈椎、上段胸椎(T1～4)、中段胸椎(T5～8)、下段胸椎(T9～12)、上段腰椎(L1、2)、下段腰椎(L3～5)、骶椎,比较MRI与核素显像对该部位病变的显示情况.结果48例患者,MRI共检查173个区段,其中显示阳性的84个区段中共计210个病灶,确诊("真阳性")206个,漏诊("假阴性")4个,无"假阳性",其诊断敏感性为98.1%.核素骨显像与之相对应的84个区段上,病灶确诊("真阳性")142个,漏诊("假阴性")49个,另有"假阳性"52个,其诊断敏感性为73.8%.结论在显示脊柱转移瘤方面,MRI较核素骨显像更具敏感性和特异性,但受扫描范围的限制,目前核素骨显像仍是筛选肿瘤患者骨转移的首选方法.

Comparison of MRI and Radionuclide Bone Display in Defecting Spinal Metastases

Objective:To compare the value of MRI and radionuclide bone display in diagnosis of spinal metastases.Methods:MRI and radionuclide bone display were obtained simultaneously in 48 patients proved to have bone metastases.The spinal was divided into cervical,upper thoracic(T1-4),middle thoracic(T5-8),lower thoracic(T9-12),upper lumbar(L1,2),lower lumbar(L3-5) and sacral regions and compare the demonstration of the lesions using MRI and bone scan.Results:In all the 48 patients,173 locations were examined by MRI and there were 210 lesions of 84 locations which were proved to be metastasis in the scan field of MRI.In all the lesions,MRI showed that the true positive was 206,the false negative was 4,the false positive was 0;and the diagnostic sensitivity was 98.1%(206/210).As regarded to the radionuclide bone display,the true positive was 142,the false negative was 49,the false positive was 52;and the diagnostic sensitivity was 73.8%(142/243).Conclusions:In the evaluation of bone metastasis,MRI appears to be more sensitive than radionuclide bone display.However,the disadvantages may be confined by the limited scan field of MRI.Radionuclide bone display is an initial choice to evaluate osseous metastasis of patients with cancer at present.