肺癌骨转移骨闪烁现象的CT表现

发布时间：2018-02-26 12:32

本文关键词： 肺肿瘤骨肿瘤肿瘤转移体层摄影术螺旋计算机放射性核素显像二膦酸盐类治疗结果　出处：《中国医学影像学杂志》2015年12期 　论文类型：期刊论文

【摘要】：目的骨闪烁现象在核素骨显像对骨转移瘤疗效监测中的描述比较详尽,而MSCT对该现象的研究鲜有报道,且此现象易被误认为疾病进展。本文探讨经伊班膦酸治疗后的肺癌骨转移患者CT骨闪烁现象及其CT特征,以提高对此现象的认识。资料与方法回顾性分析45例经临床和病理确诊为肺癌骨转移患者经伊班膦酸治疗前、治疗后3、6个月的临床资料和影像学资料,对治疗后3个月骨闪烁组、疾病进展1组及疾病进展2组骨转移灶的CT值及CT特征进行比较。结果骨闪烁现象的发生率为6.7%(3/45)。治疗后3个月,骨闪烁组、疾病进展1组的CT值与治疗前比较,差异均有统计学意义(t=-5.787、-2.788,P0.001、P0.05),疾病进展2组治疗后3个月的CT值与治疗前比较,差异无统计学意义(t=1.691,P0.05)。治疗后3个月骨闪烁组大多表现为溶骨型病灶发生成骨性硬化改变,疾病进展组大多表现为病灶新发骨膜反应、成骨或混合型病灶伴溶骨性破坏,两组比较差异有统计学意义(χ~2=10.139、8.041、4.154,P0.01、P0.05)。两组成骨型病灶密度是否增加,差异无统计学意义(χ~2=0.059,P0.05)。结论肺癌骨转移经伊班膦酸治疗后3个月,当骨转移疗效评价(疾病进展)与临床综合疗效评价(有效)结果不一致时,可以用骨闪烁现象解释,CT特征改变的分析有助于其与疾病进展的鉴别。
[Abstract]:The purpose of bone scintigraphy phenomenon in radionuclide bone imaging in monitoring the therapeutic effect of bone metastasis is described in detail, and MSCT few studies on this phenomenon, and this phenomenon may be mistaken for disease progression. This paper discusses the CT and CT features of patients with bone metastasis from flicker ibandronic acid after treatment of lung cancer with bone, to raise awareness this phenomenon. Materials and methods: analysis of 45 cases of clinical and pathologic diagnosis of bone metastasis in lung cancer patients after ibandronate treatment before the review, 3,6 months after treatment of the clinical data and imaging data of 3 months after the treatment of bone scintigraphy group, disease progression in 1 group and 2 group of metastatic bone disease the range CT value and CT characteristics were compared. The results of bone scintigraphy phenomenon occurred in 6.7% (3/45). After 3 months of treatment, bone scintigraphy group, compared with before treatment of disease progression 1 group CT, the differences were statistically significant (t=-5.787, -2.788, P0.001, P0.05). The progress of disease treatment in the 2 groups after 3 months of CT compared with before treatment, the difference was not statistically significant (t=1.691, P0.05). 3 months after the treatment of bone scintigraphy was characterized by osteolytic lesions bone sclerosis, disease progression was characterized by lesions of new bone or periosteal reaction mixture type of lesions with osteolytic destruction, there was significant difference between two groups (~2=10.139,8.041,4.154, P0.01, P0.05) two. The composition of bone lesions density increased, the difference was not statistically significant (~2=0.059, P0.05). After ibandronate treatment 3 months after the conclusion of bone metastasis of lung cancer, when the evaluation of curative effect of bone metastasis (disease progress) evaluation and clinical comprehensive efficacy (effective) were inconsistent, can be explained by bone flicker phenomenon, analysis of characteristics of CT change is helpful in differentiating progress with the disease.

【作者单位】：新疆医科大学附属肿瘤医院CT室;邵阳市中心医院CT室;新疆医科大学附属肿瘤医院核医学科;
【分类号】：R734.2;R730.44

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