脊柱转移瘤的MRI与CT诊断对照研究

Comparative analysis of MRI and CT in diagnosis of spinal metastases

目的:对照分析52例脊柱转移瘤磁共振成像(Magnetic resonance imaging,MRI)及CT表现,比较其敏感性与特异性,以提高脊柱转移瘤的早期诊断率。方法:52例脊柱转移瘤均经病理和临床证实,原发肿瘤主要为肺癌、乳癌、鼻咽癌等,对52例脊柱转移瘤患者进行同期CT及MRI检查,比较脊柱转移瘤在两种检查方法上的表现。结果:52例脊柱转移瘤共发现176个椎骨异常、76处椎管受累、68处椎旁软组织肿块、47处椎体压缩骨折。Ⅰ期脊柱转移瘤:MRI检出21块,CT未能检出。Ⅱ期:MRI、CT分别检出86块、52块。Ⅲ期:MRI、CT分别检出68块、61块。MRI、CT诊断脊柱转移瘤的检出率分别为99.4%、64.2%,MRIT1WI表现为低信号(86.9%)或其它异常信号(13.1%),T2WI表现为高信号(60.8%)或其它异常信号(39.2%)。结论:MRI的敏感性高于CT,两种检查方法具有互补性,联合应用可提高脊柱转移瘤诊断的敏感性和准确性。

Objective：To analyse the findings of MRI and CT in the diagnosis of spine metastases in 52 cases,and compare their sensitivity and specificity,in order to increase the early diagnosis rate of spinal metastases.Methods：The most common sources of skeletal metastases were carcinomas of lung,breast,nasopharynx.MRI and CT were performed in 52 patients with metastatic tumor.The detectability for vertebral metastasis was compared between the two modalities.Results：Of the 52 cases,there were destructions of 176 vertebral bodies,76 lesions of spinal canal involvement,68 paravertebral soft tissue.masses and pathological fractures of 47 vertebral bodies.In the cases of stage Ⅰ spinal metastases：21 were detected by MRI and nothing was detected by CT.In the cases of stage Ⅱspinal metastases：86 were detected by MRI;52 were detected by CT.In the cases of stage Ⅲ spinal metastases：68 were detected by MRI;61 were detected by CT.The sensitivity of spinal metastases by MRI（99.4%） higher than CT（64.2%）.MRI demonstrated decreased signal intensity（86.9%）and other abnormal signal intensity（13.1%）on T1WI and increased signal intensity（60.8%）and other abnormal signal intensity（39.2%）on T2WI.Conclusion：The sensitivity and specificity of MRI is higher than that of CT.Two methods are complementary to each other,so MRI combined with CT can improve the sensitivity and accuracy in the diagnosis of spinal metastases.