几种影像方法对脊柱转移瘤诊断的比较

目的 :分析 93例脊柱转移瘤的MRI、ECT、SCT、X线平片征象 ,以提高脊柱转移瘤的早期诊断率。方法 :回顾性分析 93例经手术病理或随访证实的脊柱转移瘤的MRI、ECT、SCT、X线平片表现。结果 :93例脊柱转移瘤共发现2 79个椎骨异常、184处椎管受累、12 0处椎旁软组织肿块、12 0处椎体病理性骨折。MRIT1 WI表现为低信号 73 .3 %( 198/2 70 ) ,T2 WI表现为高信号 62 .2 %( 168/2 70 ) ,FS T2 WI表现为高信号 85 .2 %( 2 3 0 /2 70 ) ;ECT检出的 2 61处病灶表现为多处放射性浓聚或单发放射性浓聚 ;CT检出 184处病灶表现为局限性或大片骨质破坏 ;X线平片检出的 92处表现为骨质破坏。结论 :MRI及ECT敏感性高于SCT和X线平片 ,MRI、SCT、X线平片特异性高于ECT ;MRI是诊断脊柱转移瘤一种高敏感性和特异性的方法 ,优于ECT、SCT、X线平片 ;脊柱转移瘤首选ECT并结合X线检查 ,必要时SCT或 /和MRI检查。

A comparative study of different imaging method for diagnosis of spinal metastasis

Objective:To analyze and compare the findings,sensitivity and specificity of conventional MRI,ECT,SCT and radiography in the diagnosis of spinal metastasis.Methods:The MRI appearances of 93 cases of spinal metastasis that were proved by clinical pathology were analyzed, and compared with the findings on ECT,CT and radiography.Results:There were destructions of 279 vertebral bodies,184 lesions of spinal canal involvement,120 paravertebral soft tissue masses and pathological fractures of 120 vertebral bodies. MRI of 270 vertebral bodies demonstrated decreased signal intensity (73.3%) on T 1WI and increased signal intensity (62.2%) on T 2WI. 261 multiple or single abnormal foci of vertebral body appeared as increased radio nuclide activity on ECT.CT showed bone destruction of 184 vertebral bodies,but X ray showed only 92.Conclusion:The sensitivity of MRI and ECT is significantly higher than that of SCT and radiography. And the specificity of MRI,SCT and X ray is significantly higher than that of ECT. MRI is of high sensitivity and specificity in the diagnosis of spinal metastasis, and is superior to ECT,SCT and plain X ray. ECT combined with conventional X ray should be the initial imaging method for spinal metastasis supplemented by SCT or MRI if necessary.