长骨转移瘤的影像学诊断

发布时间：2017-12-28 06:18

本文关键词：长骨转移瘤的影像学诊断　出处：《医学影像学杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的探讨长骨转移瘤的影像学特点,提高诊断准确率。方法选择具有明确原发病史或病理证实的45例长骨转移瘤患者为研究对象,对其骨转移瘤病灶的X线、CT和MRI影像表现进行回顾性总结及分析。其中X线检查18例,CT检查26例,MR检查18例(部分患者同时做2种或3种检查)。结果 X线发现20处病灶的基本特点为呈不规则形、多发斑点虫蚀样破坏或类椭圆形透亮区。无论累及骨端还是累及骨干病变,均伴有周围骨质破坏,并部分相邻皮质伴有不连续条带状骨膜增生。CT发现27处病灶均呈溶骨性骨质破坏,破坏范围可单侧或四周,部分周围形成软组织肿块。累及骨干分为皮质型和常见型。MRI发现20处病灶表现为长T1长T2、压脂像为高信号。结论长骨转移瘤在影像学表现上具有多样化特点,具体在X线、CT、MRI表现各自具有其特征性。相对而言CT、MRI在敏感性方面显示出较显著优势,尤其是MRI在发现早期髓腔病变具有较高敏感性。但X线检查在骨膜反应方面则优于其他检查。若将X线、CT和MRI三者相结合进行综合分析验证,对于诊断长骨转移瘤和与骨其他病变相鉴别具有显著意义,可提高诊断准确率。
[Abstract]:Objective to explore the imaging features of long bone metastases and to improve the accuracy of diagnosis. Methods a total of 45 patients with long bone metastases who had a clear history of primary pathology or confirmed by pathology were selected. The X-ray, CT and MRI imaging findings of bone metastases were retrospectively analyzed. There were 18 cases of X - ray examination, 26 cases with CT, 18 cases with MR examination (2 or 3 examinations). Results X-ray findings showed that the basic features of the 20 lesions were irregular, multiple spots and oval - like areas. It was associated with bone destruction and adjacent cortex with discontinuous banded periosteal hyperplasia, whether involved in the end of the bone or in the diaphysis. CT found that 27 lesions showed osteolytic destruction of bone, and the extent of destruction could be unilateral or around, and a soft tissue mass was formed around some of the lesions. The diaphysis is divided into cortical and common types. MRI found that 20 lesions showed long T1 long T2 and high blood pressure. Conclusion the metastatic tumor of long bone has a variety of characteristics in the imaging features, and it has its characteristics in X - ray, CT and MRI. Relatively speaking, CT and MRI showed significant advantages in sensitivity, especially MRI, which was highly sensitive to the discovery of early myeloid lesions. But the X-ray examination is better than the other examination in the periosteal reaction. If X ray, CT and MRI are combined to carry out comprehensive analysis and validation, it is significant for the diagnosis of long bone metastases and differentiation from other bone lesions, which can improve the accuracy of diagnosis.
【作者单位】：山东省青岛市商业职工医院影像科;青岛大学附属医院影像科;
【分类号】：R738.1;R730.44;R445.2
【正文快照】： 骨转移瘤约占全身转移瘤的15%~20%,仅次于肺及肝转移,居第三位[1],但长骨转移瘤发病率相对较低。本文对45例长骨转移瘤患者进行回顾性研究,以提高对本病的影像学认识。1资料与方法1.1一般材料45例长骨转移瘤患者中,男23例,女22例,年龄32~77岁,平均年龄55.6岁。原发病灶不明者5

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