脊柱成骨型转移瘤的CT表现

CT FEATURES OF SPINAL OSTEOGENIC METASTASES

目的探讨脊柱成骨型转移瘤的CT表现及其鉴别诊断。方法回顾性分析经临床病理证实的50例脊柱成骨型转移瘤病人的CT资料,对病灶的形态、密度、累及椎体、病灶边缘骨质改变等指标进行分析。结果50例脊柱成骨型转移瘤病人共扫描脊椎410个,220个脊椎受累,发现成骨型转移病灶460个,其中356个病灶累及椎体,104个累及附件。累及椎体的356个病灶根据范围和形态可分为全椎体形45个,非全椎体形311个(结节形128个,环形63个,不规则形120个);356个病灶中177个病灶皮质受累,出现皮质增厚,外缘毛糙、锯齿样改变或光滑。累及附件的104个病灶根据密度可分为磨玻璃样高密度34个,云絮样高密度26个,象牙质样高密度30个,混合型高密度14个。结论成骨型转移瘤病灶CT表现具有一定特征,多数可与其他成骨性病变鉴别。

Objective To discuss the value of CT feature in differential diagnosis of spinal osteogenic metastasis（SOM）.Methods A retrospective review was done for CT data of 50 patients with clinicopathologically confirmed SOM.The form and density of the lesion,vertebral body involved,and changes of bony margin were analyzed. Results A total of 410 vertebrae were scanned in the 50 patients,of which,220 vertebrae involved,and 460 lesions of osteogenic metastases found,including 356 lesions involved vertebrae and 104 lesions involved attachments.The 356 lesions that involved vertebral body were divided into whole vertebrae shape（n=45）,non-whole vertebrae shape（n=311）-including nodular shape（n=128）,circular shape（n=63）and irregular shape（n=120）-according to the scope and shape of the lesions involved.Of the 356 lesions,the cortex of 177 lesions was involved,which was thickened,with coarse of outer margin,sawtooth-like changes or smooth and glossy.Of the 104 lesions that involved the attachments could be divided into ground-glass hyperdense（n=34）,cloud-like hyperdense（n=26）,ivory-like hyperdense（n=30）and mixed hyperdense（n=120）. Conclusion Osteogenic metastasis has its certain characteristic manifestations on CT,most of them can be distinguished from other osteogenic lesions.