转移性骨肿瘤漏误诊原因的影像学分析

Imaging Analysis for Missed or Mistaken Diagnosis of Bone Metastases

目的 分析转移性骨肿瘤漏、误诊的原因 ,提高对该病影像诊断水平。材料与方法 回顾分析资料完整的转移性骨肿瘤10 5例 ,其原发肿瘤主要为肺癌、前列腺癌、消化道癌及乳癌等。所有病例均摄X线平片 ,其中CT检查 3 1例 ,MR检查 2 1例 ,ECT检查 3 4例。结果 骨转移瘤以多发、溶骨型为主。初次影像检查漏、误诊分别为 :X线平片 3 5例 ,CT 5例 ,MR及ECT各 1例。结论 影像检查首选ECT和X线平片 ,有条件时最好作CT或MRI检查 ,并做必要的鉴别诊断。

Objective To analyze the causes leading to missed or mistaken diagnosis of bone metastases, to get a better understanding of imaging features of bone metastases.Materials and Methods Imaging findings of metastatic bone tumors in 105 patients were retrospectively analyzed, most of which originated from the cancers of lung, prostate, gastrointestinal tract or breast. Plain X ray films were performed in all patients, and additional CT scan in 33, MRI in 21 and ECT in 34 cases.Results Bone metastases mainly presented as multiple lytic lesions. The number of missed or mistaken diagnosis on initial imaging examination was 35 cases for plain film, 5 for CT scan, one each for MRI and ECT.Conclusion ECT, together with plain film, is of choice for the initial imaging examination of bone metastases, while MRI and CT, when available, had better to be performed as well.