恶性骨肿瘤假体保肢术后的影像学监测研究

发布时间：2018-04-02 20:12

本文选题：超声　切入点：恶性骨肿瘤　出处：《中国超声医学杂志》2017年01期

【摘要】：目的通过对恶性骨肿瘤假体保肢术后病例进行局部影像学监测,探讨该病术后在超声影像学监测中的应用价值。方法对44例恶性骨肿瘤假体保肢术后病例进行定期(3个月)监测,均行超声、局部X线检查和~(99m)Tc-MDP全身骨扫描。超声检查部位包括原发病灶周围软组织、区域淋巴结、患侧肢体血管,复发病例中1例行MRI检查,1例行CT检查。结果超声发现9例局部复发,均经手术病理证实。其中1例局部复发,并乆窝淋巴结转移、乆静脉血栓,1例腓静脉及比目鱼肌静脉血栓。超声诊断局部复发或转移的灵敏度和特异度均高于X线检查和~(99m)Tc-MDP全身骨扫描,而MRI及CT受人工假体伪影干扰,对病灶的显示不够清晰。结论超声可用于恶性骨肿瘤假体保肢术后的局部影像学监测,为临床选择合理的干预措施提供依据。
[Abstract]:Objective to investigate the value of ultrasonic imaging monitoring in patients with malignant bone tumor after prosthetic limb salvage.Methods 44 cases of malignant bone tumor after prosthetic limb salvage were monitored regularly (3 months), all of them were examined by ultrasound, local X-ray and bone scan of whole body with 99mTc-MDP.The location of ultrasonic examination included soft tissue around the primary lesion, regional lymph nodes, and blood vessels of the affected extremities. MRI was performed in 1 case of recurrence and CT was performed in 1 case.Results 9 cases of local recurrence were found by ultrasonography, all of which were confirmed by operation and pathology.One case had local recurrence and lymph node metastasis and 1 case had venous thrombosis in peroneal vein and soleus muscle vein.The sensitivity and specificity of ultrasonography in the diagnosis of local recurrence or metastasis were higher than those in X-ray and 99mTc-MDP bone scans. However, MRI and CT were affected by artificial prosthesis artifacts, so the focus was not clearly displayed.Conclusion Ultrasonography can be used to monitor the local imaging after prosthetic limb salvage for malignant bone tumor, and provide the basis for clinical selection of reasonable intervention measures.
【作者单位】：北京大学人民医院超声科;山东省济南市第四人民医院;北京大学人民医院骨与软组织肿瘤治疗中心;
【分类号】：R445;R738;R730.44

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