肺癌患者肋骨病变的SPECT/CT影像分析

SPECT/CT imaging analysis of rib lesions in patients with lung cancer

目的分析217例肺癌患者全身骨显像肋骨病灶的SPECT/CT结果。方法对全身骨显像发现肋骨病变的217例肺癌患者加行肋骨病变SPECT/CT显像,并进行分类分析。结果共发现154个肋骨放射性浓聚灶,其中良性病灶71个,包括肋骨骨折灶55个,肋软骨钙化灶11个,骨质增生灶5个;恶性病灶51个,包括破骨性转移37个,成骨性转移14个;性质待定病灶32个,CT无异常发现或表现为肋骨髓腔局部稍高密度影,多位于肋骨与肋软骨交界处。结论肺癌患者肋骨病灶性质多样,肋骨骨折、肋软骨钙化等良性病变占较大比例,诊断时要注意鉴别,避免误诊。

Objective To analyze the rib lesions of patients with lung cancer in whole body bone scan with SPECT/CT.Methods SPECT/CT scan was performed on 217 patients with lung cancer and rib lesions using planar bone scan imaging.All the rib lesions in SPECT/CT imaging were analyzed and classified.Results Totally 154 foci showing increased uptake were detected on ribs,71 lesions were benign,including 55 rib fractures,11 costal cartilages calcifications and 5 bone hyperplasia lesions.Fifty-one lesions were malignant,including 37 osteolytic damage and 14 osteoblastic metastasis lesions.Thirty-two lesions were undetermined,there were usually no abnormal changes in CT imaging or just had some high-density shadow in marrow cavity,located on ribs and costicartilage borders.Conclusion Rib lesions vary in nature in patients with lung cancer,mainly due to rib fractures and costal cartilages calcifications.Therefore great attention should be paid to distinguish and avoid misdiagnosis.