肺癌椎体转移的MRI回顾性研究

Retrospective MRI Study of Spine Metastasis in Patients with Lung Cancer

目的:评价磁共振成像技术在肺癌椎体转移诊断中的作用,回顾性研究肺癌转移灶的病理征象是否能够预测患者的预后。方法:搜集病理及随访证实的肺癌椎体转移患者30例(病理活检证实4例,核素扫描及临床随访证实26例),男17例,女13例,行脊柱MR扫描。均采用常规自旋回波(SE)T1WI、脂肪抑制序列(SPIR)、增强T1WI行矢状及横断面扫描。结果:30例肺癌患者MRI下均可见椎体信号异常。单发灶与多发灶组在原发肿瘤确诊后出现椎体转移灶时间以及椎体转移灶出现后患者的生存时间方面差异有显著性意义(t=9.66、P<0.001;t=2.52、P=0.018);无椎体附件受累与有椎体附件受累两组之间的原发肿瘤确诊后出现椎体转移灶时间、椎体转移灶出现后患者的生存时间差异有显著性意义(t=7.67、P<0.001;t=2.59、P=0.018);无椎旁软组织肿块与有椎旁软组织肿块两组之间的原发肿瘤确诊后出现椎体转移灶时间、椎体转移灶出现后患者的生存时间差异有显著性意义(t=6.43、P<0.001;t=2.86、P=0.010);无脊髓受压与有脊髓受压两组之间的原发肿瘤确诊后出现椎体转移灶时间、椎体转移灶出现后患者的生存时间差异有显著性意义(t=10.87、P<0.001;t=2.93、P=0.041)。结论:MRI能够显示肺癌椎体转移的病理改变过程,MR表现可以前瞻地预测肺癌患者的病程发展。

Objective：To assess the role of MRI in diagnosing spine metastasis in patients with lung cancer and study whether the pathologic sign of metastasis could predict the prognosis. Methods： 30 patients who had biopsy-proven lung cancer and MRI examination of spine were studied. Survival time after spine metastatic focus was diagnosed and interval time from primary tumor to spine metastasis in every patient with spine metastasis were calculated. Results：There was significant difference in the survival time after metastatic focus was diagnosed and interval time from primary tumor to spine metastasis between patients with solitary focus and patients with multiple focus （t=9.66.P=0. 001;t=2. 52.P=0. 018）. There was significant difference in the survival time and beginning time between patients with involvement of the pedicle and patients without involvement of the pedicle （t= 7.67. P=0. 001;t= 2.59.P= 0. 018）, which is the same as patients with paraspinal mass and patients without paraspinal mass （t=6.43.P=0. 001;t=2. 86.P=0. 010）,and patients with spi- nal compression and patients without spinal compression （t= 10.87. P=0. 001;t = 2.93. P = 0. 041）. Conclusion.. MRI can provide imaging basis in diagnosing spine metastasis. As a marker of disease progression, MRI of spine can reflect shortterm prognosis of the primary neoplasm.