CAJ | 학술논문

目的：探讨单光子发射型计算机断层与 X 线计算机断层扫描成像系统同机装置（SPECT／CT）全身骨显像在肺腺癌或鳞状细胞癌患者术前诊断骨转移的临床价值及影像特点。方法82例肺原发腺癌或鳞状细胞癌患者术前行99 Tcm-亚甲基二磷酸盐（MDP）SPECT／CT 全身骨显像，术前1周内对部分骨显像阳性病灶行 MRI 检查。采用χ2检验分析骨转移发生率的差异。结果82例肺癌患者中腺癌38例，鳞状细胞癌44例，发现骨转移38例，发生率为46．3％。其中肺腺癌的骨转移发生率较鳞状细胞癌略高，分别为57．9％（22／38）和36．4％（16／44），两者差异有统计学意义（χ2＝12．66，P ＝0．027）。肺腺癌或鳞状细胞癌的骨转移部位以双侧肋骨较为多见，其次为脊柱骨、骨盆骨、四肢骨、颅骨等。结论肺腺癌较鳞状细胞癌易发生骨转移，骨转移以双侧肋骨多见。肺癌患者术前行 SPECT／CT 全身骨显像筛查骨转移，对肿瘤分期及确定治疗方案具有重要价值。
목적：탐토단광자발사형계산궤단층여 X 선계산궤단층소묘성상계통동궤장치（SPECT／CT）전신골현상재폐선암혹린상세포암환자술전진단골전이적림상개치급영상특점。방법82례폐원발선암혹린상세포암환자술전행99 Tcm-아갑기이린산염（MDP）SPECT／CT 전신골현상，술전1주내대부분골현상양성병조행 MRI 검사。채용χ2검험분석골전이발생솔적차이。결과82례폐암환자중선암38례，린상세포암44례，발현골전이38례，발생솔위46．3％。기중폐선암적골전이발생솔교린상세포암략고，분별위57．9％（22／38）화36．4％（16／44），량자차이유통계학의의（χ2＝12．66，P ＝0．027）。폐선암혹린상세포암적골전이부위이쌍측륵골교위다견，기차위척주골、골분골、사지골、로골등。결론폐선암교린상세포암역발생골전이，골전이이쌍측륵골다견。폐암환자술전행 SPECT／CT 전신골현상사사골전이，대종류분기급학정치료방안구유중요개치。
Objective To investigate the clinical values and characteristics of whole body bone ima-ging (SPECT/CT)in detecting bone metastases in the preoperative patients with lung adenocarcinoma or squa-mous cell carcinoma for staging and determining the best treatment plan.Methods Eighty-two preoperative patients with primary pulmonary adenocarcinoma or squamous cell carcinoma performed 99 Tcm-MDP SPECT/CT whole-body bone imaging.One week before surgery,parts of positive lesions performed MRI scan.The differ-ence of the incidence of bone metastasis was analysed by χ2 test.Results In all 82 patients with lung cancer, there were 38 adenocarcinomas and 44 squamous cell carcinomas.Bone metastases were detected in 38 cases, the incidence rate was 46.3%.Of which,among lung adenocarcinoma,the incidence rate was 57.9% (22 /38),and the incidence rate was 36.4% (1 6 /44)in lung squamous cell carcinoma,and the difference was sta-tistically significant (χ2 =1 2.66,P =0.027).The most common area was bilateral ribs,followed by vertebra, pelvis,bones of the extremities and skull.Conclusion Lung adenocarcinoma compared with squamous cell carcinoma is prone to bone metastases,and bone metastases are more common in bilateral ribs.It has important value that whole body bone imaging in screening for bone metastases of pre-operative patients with lung cancer for staging and making the treatment plan.