长骨转移性肿瘤的MRI表现

MRI Appearances of Metastasis in Long Tubular Bone

目的：探讨长管状骨转移性肿瘤ＭＲＩ表现和诊断价值。材料和方法：回顾性分析手术和病理证实的长管状骨转移性肿瘤１７例（共２３骨受犯）的ＭＲＩ表现，并和Ｘ线平片相对照。所有ＭＲＩ设备为场强１．５Ｔｅｓｌａ的Ｍａｇｎｅｔｏｍ ｖｉｓｉｏｎ。结果：长管状骨近侧干骺端是高发区（１７／２３）。骨破坏有三种类型：虫蚀样（７／２３）、结节样（１１／２３）和肿块样（５／２３）。大多数病灶的信号强度不均匀（１９／２３），Ｔ１ＷＩ多为不均匀低信号（１５／２３），Ｔ２ＷＩ和ＳＴＩＲ则多为不均匀高信号（１３／２３）。其他ＭＲＩ表现：水肿（１２／２３），软组织肿块（７／２３），关节受犯（７／２３）和血管改变（２／２３）等。结论：ＭＲＩ对长管状骨转移性肿瘤所造成的骨髓和周围软组织的变化十分敏感，所以它对长管状骨转移的诊断具有重要的意义。

The MRI manifestations and diagnostic value in long tubular bone metastasis were evaluated. Materials and Methods: Twenty-three metastatic lesions of 17 cases in long tubular bone verified by surgery and pathology were studied with MRI (1.5 Tesla, Magnetom Vision). Their MRI findings were analysed and compared with X-ray and pathological findings retrospectively. Results: Most of lesions (17/23) were located in proximal metaphysis. The patterns of bone destruction could be classified into 3 types f moth-eaten (7/23), small nodules with relatively defined margin (11/23) and big osteolytic masses (5/23). Most of lesions had an inhomogeneous signal intensity (19/23), mainly low signal (15/23) on SE TIWI, high signal (13/23) on SE T2WI and STIR images. Edema, soft tissue mass, joint involvement and vascular changes were found in 12, 7, 7 and 2 lesions respectively. Conclusion: MRI is very sensitive to show the early changes in bone marrow and surrounding soft tissue so it plays an important role in the diagnosis of long tubular bone metastasis.