ECT、CT及MRI的骨转移瘤影像特点分析

Analysis of Imaging Features of ECT, CT and MRI of Bone Metastatic Tumors

目的探讨分析发射型计算机断层扫描(ECT)、电子计算机断层扫描(CT)及核磁共振成像(MRI)的骨转移瘤的影像学特点及诊断价值。方法选取四川省肿瘤医院、四川省骨科医院2012年1月~2018年12月收治的100例拟诊断为骨转移瘤患者为研究对象,以病理结果为金标准,分析三种影像学方法的灵敏度、特异性、阳(阴)性预测值以及影像学特点。结果 100疑似骨转移瘤患者中,单独行CT检查者26例,MRI检查者40例,ECT检查者5例;行CT联合MRI者15例,CT联合ECT者5例,MRI联合ECT者7例,CT、MRI、ECT三者均检查者2例;CT诊断的灵敏度为0.733、特异度为0.333;MRI诊断的灵敏度为0.833,特异度为0.313;ECT诊断的灵敏度为0.929、特异度为0.400。结论三种影像学方法对于骨转移瘤均具有典型表现,ECT与MRI具有较高的诊断灵敏度,对于骨转移瘤的检出率更高,而临床应结合多种影像学手段及临床表现作出诊断。

Objective To explore and analyze the imaging features and diagnostic value of emission computed tomography(ECT), computed tomography(CT) and magnetic resonance imaging(MRI) of bone metastatic tumors. Methods 100 cases of patients who were diagnosed as bone metastatic tumors in Sichuan cancer hospital and Sichuan orthopedic hospital from January 2012 to December 2018 were selected for the study. The pathological results were used as the gold standard to analyze the sensitivity, specificity, positive(negative) predictive values and imaging features of the three imaging methods. Results Among the 100 patients suspected as bone metastatic tumors, 26 cases were examined by CT alone, 40 cases by MRI and 5 cases by ECT. 15 cases were examined by CT combined with MRI, 5 cases by CT combined with ECT, 7 cases by MRI combined with ECT, and 2 cases by CT, MRI and ECT. The sensitivity and specificity of CT diagnosis were 0.733 and 0.333. The sensitivity and specificity of MRI diagnosis were 0.833 and 0.313. The sensitivity and specificity of ECT diagnosis were 0.929 and 0.400. Conclusion Three imaging methods have typical manifestations for bone metastatic tumors. ECT and MRI have high diagnostic sensitivity, and high detection rate of bone metastatic tumors. Clinical diagnosis should be combined with various imaging methods and clinical manifestations.