CT在脊柱转移瘤诊断及鉴别诊断中的价值观察

Value of CT in the Diagnosis and Differential Diagnosis of Spinal Metastases

目的观察探讨电子计算机断层扫描(CT)在脊柱转移瘤诊断及鉴别诊断中的价值。方法回顾性分析2017年10月至2019年10月期间医院收治且经病理证实为脊柱转移瘤的62例患者全部CT影像学资料,分析其CT特点。结果62例脊柱转移瘤患者CT表现分为溶骨型、成骨型和混合型,其中溶骨型40例(64.52%),成骨型9例(14.52%),混合型13例(20.96%);病变累及腰椎32例、胸椎15例、颈椎7例,胸腰段交界3例,骶腰段交界3例,骶椎2例,病变累及部位腰椎、胸椎以及颈椎占比87.10%;单椎体、2个椎体、3个椎体以及3个以上椎体分别累及10例、22例、25例以及5例。结论不同类型的脊柱转移瘤的CT影像学特点各不相同,CT对脊柱转移瘤的诊断具有明显优势,脊柱转移瘤还需要与多发性骨髓瘤、脊柱结核以及化脓性脊柱炎等鉴别诊断。

Objective To observe the value of computed tomography(CT)in the diagnosis and differential diagnosis of spinal metastases.Methods A retrospective analysis was performed on all CT imaging data of 62 patients admitted to the hospital between October 2017 and October 2019 and confirmed by pathology as spinal metastases.The CT features were analyzed.Results CT findings of 62 patients with spinal metastases were divided into osteolytic type,osteogenic type and mixed type,including 40 cases(64.52%)of osteolytic type,9 cases(14.52%)of osteogenic type and 13 cases(20.96%)of mixed type.The lesions involved lumbar vertebrae(32 cases),thoracic vertebrae(15 cases),cervical vertebrae(7 cases),thoracolumbar junction(3 cases),sacral lumbar junction(3 cases)and sacral vertebrae(2 cases),and the proportion of lesions involved in lumbar vertebrae,thoracic vertebrae and cervical vertebrae was 87.10%.Single vertebral involvement,double vertebral involvement,three vertebral involvement and more than three vertebral involvement involved 10 cases,22 cases,25 cases and 5 cases respectively.Conclusion CT imaging features of different types of spinal metastases are different.CT has obvious advantages in the diagnosis of spinal metastases.It is also necessary to differentiate spinal metastases from multiple myeloma,spinal tuberculosis and suppurative spondylitis.