骨显像、X线、CT及MRI对骨转移瘤的诊断价值

The diagnostic value of nuclide imaging,X-ray,CT and MRI in bone metastases

目的 :探讨骨显像 (ECT)、X线、CT及MRI对转移性骨肿瘤的诊断价值及漏诊、误诊原因。方法 :全组 16 8例均行ECT及X线检查 ,CT检查 6 8例 ,MRI检查 6 6例。原发肿瘤为肺癌 (32 .1% ) ,乳腺癌 (2 6 .8% ) ,前列腺癌 (19% ) ,鼻咽癌(4.2 % )和甲状腺癌 (3.6 % )等。结果 :ECT阳性率 88% ,X线阳性率 5 7% ,CT阳性率 6 5 % ,MRI阳性率 88%。相同扫描野 ,ECT比X线多检出 16 2个病灶 ,比CT多 5 6个 ,比MRI少 15个病灶。结论 :MRI与ECT均有较高的敏感性 ,MRI的特异性高。骨转移应首选ECT并结合X线检查 ,必要时直接做MRI。

Objective:To analyse the diagnostic value and the cause leading to missed of nuclide imaging,X-ray,CT and MRI in bone metastases.Methods:The most common sources of skeletal metastases were carcinomas of lung (32.1%) breast(26.8%) and prostate gland (19.0%).Plain X-ray film and ECT were preformed in all patients and additional CT scan in 68,MRI in 66 cases.Results:The positive rate in ECT were 88%,X-ray,57%,CT 64.7%,MRI 88%. The same scan ranges ECT discover more 162 foci than X-ray,more 56 foci than CT and less 15 than MRI.Conclusion:The sensitivity of MRI and ECT were singnificantly higher,the specificity of MR is better,ECT in combination with conventional radiograph should be the initial imaging for bone metastases supplemented if necessary by MR.