肺癌骨转移单光子发射计算机断层显像术放射性核素骨显像特点分析

目的 分析肺癌核素骨显像的影像特征,评估单光子发射计算机断层显像术(SPECT)放射性核素骨显像诊断肺癌骨转移的临床价值.方法 177例确诊为肺癌的患者进行99mTc-MDP骨显像检查,对骨转移的症状、部位、数量与病理类型进行回顾性分析.结果 肺癌骨转移发生率为45.8%(81/177),其中多发性骨转移69例,占骨转移者的85.2%(69/81).腺癌骨转移发生率为69.0%(40/58),鳞癌为41.3%(19/46),小细胞癌为32.5%(13/40),未分化癌为27.3%(9/33),腺癌骨转移发生率与其他类型癌骨转移发生率比较差异有统计学意义(P＜0.05);共发现转移灶526处,部位以胸部为最多,共212处(40.3%),其他依次为脊柱168处(31.9%)、盆腔73处(13.9%)、四肢62处(11.8%)、颅骨11处(2.1%).结论 肺癌骨转移以多发病灶较为常见,部位以胸部、脊柱多发.腺癌骨转移发生率最高.肺癌患者应常规进行放射性核素骨显像,这对疾病的分期、治疗方案的选择、预后评估均有重要意义.

Characteristics of radionucilde bone imaging in patients of lung cancer with bone metastases

Objective To explore radionuclide bone imaging characteristics of lung cancer patients and evaluate the clinical significance of bone imaging in the diagnosis of lung cancer patients with bone metastases.Methods One hundred and seventy-seven patients with diagnosed lung cancer were examined by 99mTc -MDP bone imaging,and the symptoms,sites,quantity and pathological types of bone metastases were reviewed and analyzed.Results Total bone metastases ratio of lung cancer was 45.8%(81/177),and 85.2 % (69/81) patients had multiple bone metastases.There was a statistical significance of bone metastases in adenocarcinoma patients (69.0%,40/58),compared with patients of other types of lung cancersquamous cell cancer (41.3%,19/46),small cell cancer ( 32.5%,13/40),undifferentiated carcinoma ( 27.3%,9/33)](P＜0.05).Bone metastases happened in 526 places: thoracic bones 212 places (40.3%),vertebras 168 places (31.9%),pelvic bones 73 places (13.9%),extremities 62 places (11.8%),and skull 11 places (2.1%).Conclusions Multiple bone metastases is more frequent in lung cancer patients.The most frequent metastatic sites are thoracic bones and vertebras.Bone metastases of adenocarcinoma is more easily than other types of lung cancer.All the patients with lung cancer should perform radionuclide bone scan,which is significant for staging,selecting therapy methods and the evaluating prognosis of the disease.