摘要
目的研究核素骨显像(bone scintigraphy,BS)联合磁共振成像(magnetic resonance imaging,MRI)检查对脊柱转移瘤的鉴别及确诊价值,并探讨两者检查的优劣势,以提高诊断率。方法对54例恶性肿瘤患者进行核素BS与脊柱MRI检查,分别阅读各自发现的病灶,再两者对比阅读发现的病灶,随访直至确诊,验证两者结合检查对提高诊断率的可行性。结果 54例患者,BS阳性44例(81.5%),MRI检查阳性43例(79.6%),两者比较差异无统计学意义(P=0.808);BS检出病灶数130个(89.0%),MRI检出病灶数127个(87.0%),两者比较差异无统计学意义(P=0.589)。BS联合MRI检查发现骨转移病例52例(96.3%),与任一检查方法比较差异均有统计学意义(P值分别为0.014、0.008);BS联合MRI检查发现骨转移病灶数145个(99.3%)。结论BS较MRI能更有效地检出全身转移病灶,是早期诊断骨转移瘤的首选方法;MRI检查特异性更高,解剖定位明确,并能显示软组织病灶;两者联合应用可优势互补,大大增强了对脊柱转移瘤诊断的准确性、特异性和敏感性,提高了骨转移瘤的早期诊断率。
Objective To study the value of bone scintigraphy (BS) and magnetic resonance imaging ( MRI ) examination in the differential diagnosis of spinal metastases, and to discuss the advantages and disadvantages of the two examinations for improving the diagnosis rate. Methods BS and MRI were performed in 54 patients with malignant tumor. The patients were then followed until the metastases were confirmed. The results of BS and MRI were compared independently to the clinical results. Results In 54 patients, BS was positive in 44 ca- ses (81.5%), MRI examination positive in 43 cases (79.6%), and the difference was not statistically significant (P =0. 808) ; the BS de- tection number of lesions was 130 (89.0%), the number of lesions detected in MRI was 127 (87.0%), and the difference was not statisti- cally significant (P = 0.589). The joint examination of BS and MRI revealed bone metastasis in 52 cases (96.3%), and the difference was statistically significant compared with any inspection method (P = 0. 014,0. 008 ) ; BS united with MRI found 145 lesions of bone metastases (99.3%) , and almost all spinal metastases were found. Conclusion BS is more efficient in detecting whole osseous metastases foci than MRI, which is the first choice for osseous metastases diagnosis; MRI has the higher specificity, which can show the dissection location and the soft tissue lesions clearly. The combination of two exerts complementary advantages, greatly enhances the accuracy, sensitivity and speci- ficity of the diagnosis of spinal metastasis, and improves the early diagnosis rate of spinal metastases.
出处
《安徽医学》
2013年第4期478-481,共4页
Anhui Medical Journal
关键词
骨显像
磁共振成像
脊柱转移瘤
Bone scintigraphy
Magnetic resonance imaging
Spinal metastases