摘要
目的 :探讨脊柱骨转移癌放射性核素骨显像表现及其临床应用。方法 :3 70例放射性核素骨显像诊断的脊柱骨转移癌病例 ,多数有原发肿瘤的病史 ,部分可疑病例经手术病理和 /或X线平片和 /或CT和 /或MRI证实。分析其放射性核素骨显像的表现。转移灶的确定 :与邻近椎体对比 ,凡骨显像表现为明显的放射性聚集或放射性缺损和 /或MRI的T1加权表现为低信号强度且T2 加权表现为高低混杂或高信号强度和 /或和 /或X线平片或CT显示骨质破坏的椎体均认为是骨转移。结果 :①脊柱骨转移癌骨显像多表现为多椎体异常放射性聚集 ,胸椎多于腰椎 ,病灶常呈圆形或类圆形 ,常合并脊柱外骨病灶 ,以胸廓、骨盆常见 ;②恶性肿瘤不同 ,病灶部位、数目及脊柱外骨病灶的位置有所不同。结论 :①骨显像表现为多个椎体异常放射性聚集可诊断为转移癌 ,在单个椎体病灶病例的随访中 ,病灶可能暂时转阴 ,随后变成冷区 ,应结合临床原发肿瘤病史及CT或MRI综合判断 ;②脊柱转移癌好发于胸椎 ,其次是腰椎 ,多个椎受累常见 ,常伴脊柱外骨转移。③不同的恶性肿瘤其脊柱转移癌好发部位、病灶数目及合并脊柱外骨转移的部位有差别 ,全面分析骨显像结果对早期诊断。
Objective: To analyze the feature of vertebral metastasis on planar skeletal scintigraphy and evaluate its clinical application. Methods: The appearance of vertebral metastasis in 370 cases, diagnosed by means of planar skeletal scintigraphy, was retrospectively analyzed. Most patients were with history of primary tumors.Part of suspected cases were confirmed by histopattology,radiography,CT and MRI.Results:①Vertebral metastasis on scintiphotography appeared abnormal bony trace uptake, which was more frequently seen in thoracic vertebra than in lumbar one. The lesion often appeared round shaped or round like. Moreover, other extravertebral bony metastatic foci especially in thoracic and pelvic bone were frequently seen.② With different malignant tumor, the site and number of lesions inside or outside the bony spine varied also. Conclusion: The abnormal trace uptake of multiple vertebras on scintiphotography can be diagnosed as a bony metastasis.However, the diagnosis of lesion in single vertebra, which could turned to cold spot from hot spot on scintigraphy during the follow up, should be made with reference to clinical history or the CT or MRI findings . The feature of vertebral metastasis on scintigraphy is helpful in early diagnosis and treatment as well as detection of the cause of vertebral metastasis.
出处
《放射学实践》
2000年第1期46-48,共3页
Radiologic Practice
