骨转移癌的核素骨显像分析

目的分析骨转移癌全身骨显像的特点,提高核素骨显像的诊断水平.方法638例恶性肿瘤患者行99TCm-MDP全身骨显像并分析.结果①恶性肿瘤患者中有67.9%发现骨转移,病灶分布分别为脊柱34%、肋骨30%、骨盆18%、四肢骨10%、头颅3.3%、胸骨锁骨2.4%和肩胛骨2.3%.②绝大部分骨转移病灶为局限性放射性分布异常浓聚,减低仅占0.8%.骨转移以多灶为常见,单灶仅10.4%.③与X线检查对比,多数患者全身骨显像较X线片发现了数目更多和范围更广的病灶;少数患者骨转移灶X线片表现出明显的骨质破环,而骨显像上无明显的放射性分布异常.④患者主诉的328处骨痛,骨显像发现为骨转移灶达64.9%,另有271个骨转移灶无明显骨痛.结论①骨转移癌的好发部位依次为脊柱、肋骨、骨盆、四肢骨、头颅、胸锁骨和肩胛骨.②全身骨显像对骨转移癌灶的探测灵敏度明显高于X线检查.与X线检查相互配合,可提高诊断的准确性.

Analysis of nuclear total- body bone scan in bone metastases carcinoma

Objective To analysis the characteristic of bone image of metastases carcinoma to improve the diagnotic level of nuclear total-body bone scan in bone metastases carcinoma. Methods 638 cases with malignant tumor were examined by 99 TC m-MDP total-body bone scan and their images were analyzed. Results ① Among cases with malignant tumor, 67.9% cases were discovered bone metastases. Positions of metastases were distributed with spinal column 34%?rid 30%?pelvis 18%?the four limbs 10%?skull 3.3%?sternum/clavicle 2.4%and scapula 2.3%. ② The most metastases were heaviness distributed of radioactive rays, sparse distrbuted were barely discovered in 0.8%cases. There were focuses in the majority cases of matastases. Single focus occurred in 10.4% cases. ③ Compared with X-ray examine, the majority cases were discovered more amount and more extent focuses of metastases by bonescan. there were mot abmormal distribution of radioactive rays in nuckear scan in minority of patients with bone destroy in the X-ray. ④ In 328 seats of bone paintold, there were 64.9% seats discovered focus of metastases. In same cases, as well, there were 271 focuses of metastases without bone pain. Conclusion ① Occurrence frequency of bone metastases carcinoma put in proper order with spinal column?rid?pelvis?the four limbs?sku11?sternum/clavicle and scapula successively.② Sensitivity with muclear total-body bone scan is better than X-ray examine. The method of nuclear total-body bone scan united X-ray examine may raise diagnostic accuracy.