中国临床医学
中國臨床醫學
중국림상의학
CLINICAL MEDICAL JOURNAL OF CHINA
2014年
6期
633-635,639
,共4页
张一秋%石洪成%李蓓蕾%修雁%顾宇参%陈曙光%蔡良
張一鞦%石洪成%李蓓蕾%脩雁%顧宇參%陳曙光%蔡良
장일추%석홍성%리배뢰%수안%고우삼%진서광%채량
肺癌%骨转移%单光子发射计算机断层/X 线电子计算机断层扫描
肺癌%骨轉移%單光子髮射計算機斷層/X 線電子計算機斷層掃描
폐암%골전이%단광자발사계산궤단층/X 선전자계산궤단층소묘
Lung cancer%Bone metastasis%SPECT/CT
目的:探讨99 Tcm-亚甲基二膦酸盐(methylene diphosphonate,MDP)单光子发射计算机断层/CT(single photon emis-sion computed tomography/ spiral computed tomography,SPECT/CT)所显示的肺癌骨转移病灶的图像特点及 SPECT/CT 显像对肺癌骨转移的诊断价值。方法:回顾分析113例病理证实为肺癌、初次全身骨显像及 SPECT/CT 显像诊断为肺癌骨转移的患者的骨转移病灶的 SPECT/CT 图像特点,经病理诊断或再次全身骨显像及 SPECT/CT 显像随访确认,分析 SPECT/CT 显像所示肺癌骨转移病灶的部位、数量、放射性分布及 CT 表现的特点。结果:113例患者共482处病灶纳入本研究,肺癌骨转移病灶429处。肺癌骨转移病灶中位于脊柱者占50.6%(217/429),胸廓者占29.1%(125/429),骨盆者占17.0%(73/429),四肢者占2.1%(9/429),颅骨者占1.2%(5/429)。肺癌骨转移病灶 SPECT/CT 图像表现为放射性异常浓聚者占90.7%(389/429),无放射性分布异常者占9.3%(40/429);CT 图像表现为成骨性转移者占41.0%(176/429),溶骨性转移者占50.3%(216/429),混合性(兼有溶骨和成骨)转移者占4.0%(17/429),骨质形态学正常者占4.7%(20/429)。113例患者中有23例患者同时伴有良性病灶,共53处。结论:肺癌骨转移的部位以脊柱居首,胸廓次之;肺腺癌患者容易发生骨转移,以成骨性转移多见。SPECT/CT 诊断肺癌骨转移病灶的敏感度和特异性均较高。
目的:探討99 Tcm-亞甲基二膦痠鹽(methylene diphosphonate,MDP)單光子髮射計算機斷層/CT(single photon emis-sion computed tomography/ spiral computed tomography,SPECT/CT)所顯示的肺癌骨轉移病竈的圖像特點及 SPECT/CT 顯像對肺癌骨轉移的診斷價值。方法:迴顧分析113例病理證實為肺癌、初次全身骨顯像及 SPECT/CT 顯像診斷為肺癌骨轉移的患者的骨轉移病竈的 SPECT/CT 圖像特點,經病理診斷或再次全身骨顯像及 SPECT/CT 顯像隨訪確認,分析 SPECT/CT 顯像所示肺癌骨轉移病竈的部位、數量、放射性分佈及 CT 錶現的特點。結果:113例患者共482處病竈納入本研究,肺癌骨轉移病竈429處。肺癌骨轉移病竈中位于脊柱者佔50.6%(217/429),胸廓者佔29.1%(125/429),骨盆者佔17.0%(73/429),四肢者佔2.1%(9/429),顱骨者佔1.2%(5/429)。肺癌骨轉移病竈 SPECT/CT 圖像錶現為放射性異常濃聚者佔90.7%(389/429),無放射性分佈異常者佔9.3%(40/429);CT 圖像錶現為成骨性轉移者佔41.0%(176/429),溶骨性轉移者佔50.3%(216/429),混閤性(兼有溶骨和成骨)轉移者佔4.0%(17/429),骨質形態學正常者佔4.7%(20/429)。113例患者中有23例患者同時伴有良性病竈,共53處。結論:肺癌骨轉移的部位以脊柱居首,胸廓次之;肺腺癌患者容易髮生骨轉移,以成骨性轉移多見。SPECT/CT 診斷肺癌骨轉移病竈的敏感度和特異性均較高。
목적:탐토99 Tcm-아갑기이련산염(methylene diphosphonate,MDP)단광자발사계산궤단층/CT(single photon emis-sion computed tomography/ spiral computed tomography,SPECT/CT)소현시적폐암골전이병조적도상특점급 SPECT/CT 현상대폐암골전이적진단개치。방법:회고분석113례병리증실위폐암、초차전신골현상급 SPECT/CT 현상진단위폐암골전이적환자적골전이병조적 SPECT/CT 도상특점,경병리진단혹재차전신골현상급 SPECT/CT 현상수방학인,분석 SPECT/CT 현상소시폐암골전이병조적부위、수량、방사성분포급 CT 표현적특점。결과:113례환자공482처병조납입본연구,폐암골전이병조429처。폐암골전이병조중위우척주자점50.6%(217/429),흉곽자점29.1%(125/429),골분자점17.0%(73/429),사지자점2.1%(9/429),로골자점1.2%(5/429)。폐암골전이병조 SPECT/CT 도상표현위방사성이상농취자점90.7%(389/429),무방사성분포이상자점9.3%(40/429);CT 도상표현위성골성전이자점41.0%(176/429),용골성전이자점50.3%(216/429),혼합성(겸유용골화성골)전이자점4.0%(17/429),골질형태학정상자점4.7%(20/429)。113례환자중유23례환자동시반유량성병조,공53처。결론:폐암골전이적부위이척주거수,흉곽차지;폐선암환자용역발생골전이,이성골성전이다견。SPECT/CT 진단폐암골전이병조적민감도화특이성균교고。
Objective:To analyze the 99 Tcm-methylene diphosphonate single photon emission computed tomography/spiral computed tomography (SPECT/CT)fusion imaging of bone metastases in patients with lung cancer and to evaluate the value of SPECT/CT in differentiating metastases from benign bone lesions.Methods:A total of 113 patients with bone metastases from lung cancer confirmed by pathology underwent bone scintigraphy and SPECT/CT imaging.Metastatic bone sites,quantity,up-take of radiotracer,and CT manifestations of each lesion were analyzed via bone scintigraphy imaging and SPECT/CT fusion imaging.Results:A total of 482 lesions from 113 patients were analyzed in this study.Among them,429 lesions were metasta-ses.Metastatic sites included spine(50.6%),thorax (29.1% ),pelvis (17.0%),extremities (2.1%),and skull(2.1%).CT manifestations were osteoblastic (41.0%),osteolytic (50.3%),mixed (4.0%),and normal (4.7%).Among these lesions, the proportion of hot spots displayed on SPECT/CT pictures was 90.7%(389/429),and the proportion of lesions with normal uptake of radiotracer was 9.3%(40/429).There were 53 benign lesions in 23 patients with bone metastasis.Conclusions:The most frequent metastatic sites in patients with lung cancer are spine and thorax.Bone metastasis from squamous carcinoma is more com-mon than from other types of lung cancer.The common CT manifestations are osteoblastic.The sensitivity and specificity of SPECT/CT fusion images for the diagnosis of bone metastatic lesions of lung cancer are high.