脊柱成骨型转移瘤的CT表现.pdfVIP

摘要 目的探讨脊柱成骨型转移瘤的CT表现及征像的鉴别诊断价值。 方法 回顾性分析经临床病理证实的50例脊柱成骨型转移瘤患者的CT资料，对病灶的 形态、密度、累及椎体、病灶边缘骨质改变等指标进行分析。 结果 50例脊柱成骨型转移瘤患者共扫描脊椎410个，220个脊椎受累，发现成骨型转 移病灶460个，其中356个病灶累及椎体，104个累及附件。累及椎体的356个病灶 根据范围和形态可分为全椎体形45个、结节形128个、环形63个、不规则形120个。 356个病灶中，177个病灶皮质受累，出现皮质增厚，外缘毛糙、锯齿样改变或光滑。 累及附件的104个病灶根据密度可分为磨玻璃样高密度34个、云絮样高密度26个、 象牙质样高密度30个、混合型高密度14个。 结论 成骨型转移瘤病灶CT表现具有一定特征，病灶多以骨质增生硬化为主，呈磨玻 璃样、云絮样、象牙质样或混合高密度灶。病灶形态多以结节形、环形、不规则形为 主，其中环形病灶对于成骨型转移瘤的鉴别有一定的诊断价值。成骨型转移瘤病灶多 位于椎体，且病灶多位于椎体的一侧，另一侧以骨皮质为边缘，受累骨皮质均呈毛糙 样、锯齿样或光滑增厚。附件病灶少见。多数成骨型转移瘤可与其它成骨性病变鉴别 如：骨岛、畸形性骨炎、骨霍奇金病等。 硕士研究生 蔡晓男（影像医学与核医学） 指导教师 刘吉华 教授 关键词：脊柱；转移瘤；成骨型；计算机体层摄影术 Abstract Objective To discuss the value of CT performance in the differential diagnosisof spinalosteogenicmetastases. Methods Retrospectively analyzed the CT data of 50 patients with spinal osteogenic metastases.The lesions were confirmed by clinic or pathology. The morphology, density, involvement ofthe vertebrae and thechangeofbonymargin ofthelesions wereanalyzed. Results All 410 vertebrae were scanned in 50 patients.Totally 220 vertebrae were involved, and 460 osteogenic lesions were foundincluding356lesionsinvolvedvertebraee and 104lesionsinvolved attachments. According to the scope and shape, the lesions involved vertebrae were divided into the whole vertebrae shape(45), nodular shape (128) , circular shape (63) and irregular shape (120). Totally 177 lesionsinvolvedthe cortex.Theperformance included corticalthickening and outer margin coarsing,jigsaw changing or smooth.Accordingto the density, the lesions involved attachments were divided into the ground-glass hyperdensity (34),flocc hyperdensity(26), ivory-like hyperdensity(30)and mixed hyperdensity(120). Conclusion The CT imaging features of spinal osteogenic metastases has certain characteristics. Lesions mainly in bone sclerosis. Such as groun