肋骨转移瘤多种影像学检查价值及对比分析

目的：探讨影像学检查对肋骨转移瘤的诊断价值并对诊断结果进行对比分析。方法：本组38例进行如下检查：X线平片17例；CR21例；SCT胸部横断扫描并薄层重建7例；薄层横断扫描6例；薄层倾斜扫描7例；MSCT胸部横断扫描并薄层重建、二维多平面重建和三维容积成像、最大密度投影18例。结果：X线平片、CR图像利于定位，其诊断率分别为71．0％、74．3％，诊断的比较差异无显著性（P〉0．05）；SCT、MSCT利于显示病变，其诊断率分别为91．0％、92．6％，CT与前两者间诊断的比较差异有显著性（P〈0．05），说明CT扫描对肋骨转移瘤的诊断优于X线平片和CR图像。薄层CT病变诊断率均达100％，将之确定为诊断标准；2D重建可作为横断图像的补充；3D重建可立体显示骨性胸廓的全貌，利于病变的整体观察及定位。结论：CT扫描及其二维、三维重建对肋骨转移瘤的诊断具有明显的优势，与X线平片或CR图像的联合应用，具有良好的定位、定量及定性诊断作用。

Value and comparative analysis of radiologic imaging in the diagnosis of rib metastasis

Objective： To analyse and compare the value of different modalities of radiologic imaging for rib metastasis. Methods： Thirty-eight patients with rib metastasis were examined： 17 cases were examined by plain films, 21 cases underwent CR, 7 cases underwent chest SCT and thin slice reconstruction, 6 cases underwent thin slice SCT and 7 cases slope scanning; 18 cases underwent chest MSCT and thin slice reconstruction, 2D MPR, 3D VR and 3D MIP respectively. Results： In 38 rib metastases, X-ray film and CR demonstrate the location accurately and diagnostic accuracy was 71.0% and 74.3% respectively. There was no difference between them（P〉0.05）; Image of SCT and MSCT could demonstrate small rib disease and diagnostic accuracy was 91.0% and 92.6% respectively. There is significant difference between CT and X-ray film or CT and CR （P〈0.05）. Diagnostic accuracy of thin slice image is 100%, so it is used as contrast standard. 2D MPR play an assistant role to transverse image in diagnosis; 3D image could demonstrate the bony of thorax fully, so the location is clear and lesion could be viewed easily. Conclusion： SCT, MSCT, 2D and 3D reconstruction imaging have distinctive advantage in diagnosing rib metastasis, combination of conventional radiography and CR, diagnosing the character and location of the rib metastasis is the best.