核素平面骨显像与磁共振成像对于诊断脊柱骨转移瘤的对比研究

Comparison of Radionuclide Planar Bone Scans and Magnetic Resonance Imaging in Detecting Spinal Metastases

目的：探讨核素平面骨显像（ＢｏｎｅＳｃａｎ，ＢＳ）与磁共振成像（ＭＲＩ）对于诊断脊柱骨转移瘤的临床价值。材料与方法：受试者２２例，男１４例，女８例，年龄２７～８４岁，平均年龄５５８岁，全部病例均在接受骨显像前后约二个月内行磁共振检查。分析判断图像时，将脊柱分为颈椎、胸椎上段（Ｔ１－Ｔ４）、胸椎中段（Ｔ５－Ｔ８）、胸椎下段（Ｔ９－Ｔ１２）、腰椎上段（Ｌ１－Ｌ２）、腰椎下段（Ｌ３－Ｌ５）和骶椎７个区段。结果：２２例患者骨显像示１０例患者发现至少有一个区段骨转移，阳性率为４５５％，ＭＲＩ示１３例患者有至少一个区段骨转移，阳性率为５９１％，Ｐ＞００５；具有可比性的８３个区段中，骨显像示３０个区段阳性，阳性率为３６１％（３０／８３），ＭＲＩ为３３个区段阳性，阳性率为３９８％（３３／８３），Ｐ＞００５；有６９个区段两种显像诊断相同，诊断一致率为８３１％。结论：ＭＲＩ对脊柱骨转移瘤诊断的灵敏度不低于核素平面骨显像。核素平面骨显像可作为筛选肿瘤患者骨转移的首选检查。

PURPOSE:To compare the clinical value of radionuclide planar bone scans and magnetic resonance imaging in detecting spinal metastases. METHODS:22 patients were performed with Tc-99m MDP planar bone scans and corresponding spinal MR imagings within about 2 months. There were 14 male and 8 female patients with their ages ranged from 27 to 84 years old (mean 55 8 yr). The spine was divided into cervical, upper thoracic(T1-T4),middle thoracic(T5-T8), lower thoracic(T9-T12),upper lumbar (L1-L2), lower lumbar (L3-L5) and sacral regions, RESULT:Of the 22 patients, 10 patients(45 5%)had at least one lesion on bone scans; and 13 patients(59 1%)had at least one lesion on MRI. Of the 154 total vertebral regions, 83 regions can be campared with bone scans and MRI. Bone scans were positive in 30/83(36 1%)of the comparable regions; and MRI were positive in 33/83(39 8%) of the comparable regions, P>0 05. There were 69 regions (83 1%)reading concordantly on both types of study. CONCLUSION:the sensitivity of MRI in detecting vertebral metastasis is not inferior to that of bone scans. However, radionuclide bone scanning is a initial choice to evaluate osseous metastasis of patients with cancer, MRI is an essential complementary way for bone scans.