核素骨显像中单个病灶临床分析

Clinical analysis of bone scanning of solitary lesions

目的 对骨显像中单个病灶的诊断提出较为合理的分析程序。方法 采用常规99Tcm 亚甲基二膦酸盐 (MDP)骨显像 ,对获得最后诊断的 346例骨显像中单个病灶进行临床分析。 结果①单个病灶在 2 46 5例骨显像中的发生率为 15 3% (378/ 2 46 5例 )。②有肿瘤病史的 2 82例患者中 ,骨转移诊断率为 2 4 8% (70 / 2 82例 ) ;无肿瘤病史的 6 4例患者中 ,骨转移诊断率为 6 3% (4 / 6 4例 ) ,两者差异有显著性 ;总骨转移诊断率为 2 1 4% (74/ 346例 )。③在有肿瘤病史患者中 ,单个病灶的骨转移率分别为 :肺癌 36 1% (2 2 / 6 1例 ) ,乳腺癌 2 3 8% (2 0 / 84例 ) ,前列腺癌 17 2 % (5 / 2 9例 ) ,泌尿系统肿瘤 2 2 2 % (4 / 18例 ) ,消化系统肿瘤 16 9% (10 / 5 9例 ) ,其他肿瘤 2 9 0 % (9/ 31例 ) ,不同病种之间单个病灶的骨转移率差异无显著性。④无肿瘤病史患者中 ,93 7% (6 0 / 6 4例 )的单个病灶主要是良性病灶。⑤就解剖部位 :脊柱的骨转移率为 30 0 % ,骨盆为 34 2 % ,颅骨为 36 4% ,其他骨为 10 8% ,各组之间差异有显著性。结论 骨转移最好发部位为脊柱和骨盆 ;应注意“冷”区和条索状病灶 ,单个病灶的骨转移率分别为 70 6 %和 78 6 % ;得出了单个病灶临床分析程序。

Objective To analyze solitary lesions in the following aspects: ①Diagnosis of bone metastasis ②The incidences of bone metastasis in different tumors ③The most possible lesion sites indicating bone metastasis ④Morphological analysis of solitary lesions Through above clinical analysis, we have obtained a rational analysis procedure for solitary lesions on whole bone scanning Methods The bone scanning followed routine procedures The imaging agent was 99 Tc m MDP Results ①The incidence of solitary lesions in 2 465 cases on whole bone scanning was 15 3% ②The rate of bone metastasis was 24 8% in 282 patients with primary malignancy The rate of bone metastasis was 6 3% in 64 patients without primary malignancy, and the total diagnostic rate of bone metastasis was 21 4% in 346 patients ③In patients with primary malignancy, the incidences of bone metastasis of solitary lesions were as follows: bronchi cancer 36 1% (22/61); breast cancer 23 8% (20/84); prostate cancer 17 2% (5/29); other urinary cancer 22 2% (4/18);gastrointestinal cancer 16 9% (10/59); others 29 0% (9/31) There were no significant differences in different cancers ④In patients without primary malignancy, 93 7% (60/64) of solitary lesions were benign ⑤From anatomical point of view, we found the diagnostic rates of bone metastasis were as follows: 30% in spine; 34 2% in pelvis; 36 4% in skull; 10 8% in other bones There were significant differences among the groups Conclusions ①The diagnostic rate of bone metastasis in solitary lesions was 21 4% ②The most possible solitary lesions indicating osteal tumor spread are in spine, pelvic and skull ③We should pay more attention to “cold' and streak like lesions ④We have obtained a clinical analysis procedure for diagnosis of solitary lesions