核素骨显像诊断肿瘤骨转移的临床价值

Clinical value of skeletal scintigraphy in diagnosis of skeletal metastases in patients with carcinoma

目的探讨肿瘤骨转移的特点、比例以及核素骨显像对肿瘤骨转移的诊断价值。方法总结902例肿瘤患者(Ⅰ组)和96例无肿瘤史伴不明原因骨痛患者(Ⅱ组)的全身核素骨显像特征,统计骨转移所占的比例和转移特点。结果Ⅰ组:在902例患者中,未发现肿瘤骨转移的患者为579例,可疑患者97例,明确肿瘤骨转移的患者为226例(共987人次),其中全身各处肿瘤骨转移由高到低分别为16.0%(158/987),15.3%(151/987),15.2%(150/987),12.7%(125/987),8.4%(83/987),7.9%(78/987),7.3%(72/987),7.2%(71/987),4.6%(46/987),3.9%(38/987),0.9%(9/987),0.6%(6/987)。发现转移病灶个数分别为375、585、471、309、165、117、116、95、73、76、12、7,共计2401个转移灶。Ⅱ组:96例患者中,31例排除肿瘤骨转移,28例诊断为肿瘤骨转移,37例仍为可疑病例。结论放射性核素骨显像是一种灵敏度高的常规检查方法,对肿瘤骨转移的早期诊断有重要的价值。

Objective To evaluate the characteristics and distrubution of bone metastases in patients with malignant tumors by using skeletal scintigraphy. Methods Nine hundredand two patients with malignant tumors （group I ） and ninety-six patients with bone pain with unknowing reasons （group II ） were included in this study. Bone scan was underwent in every patient. Results In group I , there were 579 patients with no bone metastases and 97 suspected cases, 226 patients were with skeletal metastases （987 person-time totally）. The parts of tumor metastasis were pelvis 16.0% （158/987,375nidi）, ribs 15.3% （151/987,585 nidi）, vertebra thoracalis 15.2% （150/987,471 nidi）, lumbar vertebra 12.7%（ 125/987,309 nidi）, femora 8.4%（83/987,165 nidi）, articulatio humeri 7.9%（78/987,117 nidi）, cervical vertebra 7.3% （72/987,116 nidi）, sternum 7.2%（71/987,95 nidi）, harnpan 4.6%（46/987,73 nidi）, humeri 3.9%（38/ 987,76 nidi）,tibiofibula 0.9%（9/987,12 nidi）,ulna and oar 0.6%（6/987,7 nidi）. In group 11 , there were 31 patients with no bone metastases and 37 suspected cases, 28 patients with skeletal metastases were diagnosed. Conclusion Bone scan is a sensitive, convenient and cost effective method to detect bone metastases in patients with carcinoma.