摘要
目的 比较核素全身骨平面显像和MRI、CT及X线在脊柱转移瘤及其他脊柱疾病诊断中的价值。方法130例经手术病理诊断的脊柱疾病患者行99mTc-MDP全身骨平面显像,显示局部异常浓聚、局部异常稀疏和局部加其他部位异常浓聚或稀疏为阳性结果。所有患者均行MRI、CT、X线片三种影像检查的一种以上,其中104例行MRI、61例行CT、107例行x线片检查。结果 骨显像诊断脊柱疾病的灵敏度为:转移瘤91.7％,原发恶性肿瘤73.3％,良性肿瘤54.2％,瘤样病损81.8％,炎性病变100％,压缩性骨折100％。61.1％的转移瘤患者伴有其他部位骨骼的异常浓聚或稀疏灶(58.3％可明确诊断为骨转移瘤)。非转移瘤的其他脊柱疾病,20.2％伴有异位异常浓聚或稀疏灶。MRI、CT和X线的灵敏度分别为:转移瘤96.8％、100％和79.3％;原发恶性肿瘤95.7％、93.3％和78.3％;良性肿瘤95.0％、92.3％和54.5％;瘤样病损100％、100％和80.0％;炎性病变100％、100％和69.2％;压缩性骨折均为100％。结论 核素骨显像是诊断骨转移瘤的最佳方法。对其他脊柱疾病,几种影像技术各有其优势,而核素骨显像对判断病灶是单发抑或多发及是否伴发其他骨骼病变有较大价值。
Objective To compare the value of radionuclide bone imaging and of MR1,CT,X-ray photography in the diagnosis of spinal mctastases and other spinal diseases. Methods A total of 130 patients with various spinal diseases confirmed by histopathology received radionuclide planar bone imaging in the whole body with 99mTc - MDP. The abnormal results were named as the followings; Local high uptake of imaging agent in lesions, local low uptake, and high or low uptake in local and other bones. MRI, CT and X-ray were respectively performed in 104, 61 and 107 patients. Results The sensitivities of bone imaging for the detection of metastatic tumors, primary malignant bone tumors, benign bone tumors, tumor-like lesions, inflammatory diseases and compressed fractures were 91. 7% , 73. 3% , 54. 2% , 81. 8% , 100% and 100% , respectively. In 22 of 36 (61. 1% ) patients with metastases, bone imaging showed high or low uptakes in local and other bones. 21 of those had multiple metastases. 19 of 94 (20. 2% ) patients with non-metastatic bone lesions had high or low uptakes in local and other bones. The sensitivities of MRI, CT and X-ray were 96. 8% , 100% and 79. 3% in detecting metastatic tumors, 95. 7% , 93. 3% and 78. 3% in primary malignant bone tumors, 95. 0% , 92. 3% and 54.5% in benign bone tumors, 100% , 100% and 80.0% in tumor-like lesions, 100% , 100% and 69. 2% in inflammatory diseases, and 100% , 100% and 100% in compressed fractures, respectively. Conclusion Radionuclide bone imaging was the best choice for the diagnosis of bone metastases. For non-metastatic bone diseases, bone imaging might be helpful in distinguishing the lesions, whether they were single or multiple forces or accompanied with other bone lesions.
出处
《脊柱外科杂志》
2004年第3期142-145,164,共5页
Journal of Spinal Surgery
