X线平片CT及MRI在脊柱转移中诊断价值比较.docVIP

X线平片CT及MRI在脊柱转移中诊断价值比较 　　摘要：目的对比分析X线平片、CT及MRI在脊柱转移中的诊断价值。方法收集30例均接受X线平片、CT及MRI检查的脊柱转移瘤确诊患者，比较这3种检查手段对转移瘤的检出效果。结果三种检查方法显示脊柱转移的各种病变数目共171个。其中X线平片共检出59个病变，占总数的34.50%，诊断脊柱转移病例数9例，占总数的30.0%；CT共检出88个病变，占总数的51.46%，诊断脊柱转移病例数16例，占总数的53.33%；MRI共检出171个病变，占总数的100.0%，诊断脊柱转移病例数29例，占总数的96.67%。比较此3种方式对病变检出个数与脊柱转移瘤诊断率具有明显差异(P 　　关键词：X线平片；CT；MRI；脊柱转移；诊断价值 　　Diagnostic Values Comparison of X -ray,CT and MRI in Spinal Metastasis 　　FU Shun-bin,LI Zhen-wu,YANG Hai-li,YANG Tao,YAO Yong-gang 　　(Department of Radiology,Beijing Daxing District Peoples Hospital,Beijing 102600,China) 　　Abstract：ObjectiveTo compare and analyze the diagnostic values of X-ray,XT and MRI in the spinal metastasis.Methods30 cases of spinal metastasis patients were selected as the study objects,and all of these patients were given three examination approaches of X-ray,CT and MRI,then the examination results were compared.ResultsThe study results showed that there were 171 times displaying a variety of metastatic spinal lesions with these three methods,in which 59 times of pathological changes were diagnosed with X-ray,accounting for 34.50%,and 9 cases were diagnosed as spinal metastasis,accounting for 30.0%;88 times of pathological changes were diagnosed with CT,accounting for 51.46%,and 16 cases were diagnosed as spinal metastasis,accounting for 53.33%;171 times of pathological changes were diagnosed with MRI,accounting for 100.0%,and 29 cases were diagnosed as spinal metastasis,accounting for 96.67%.There were significant differences among the pathological changes diagnostic times and spinal metastasis dianostic rate of these three methods (P 　　3讨论 　　脊柱转移累及部位以腰、胸椎最常见，其次为颈、骶椎。原发肿瘤以肺癌、乳腺癌、前列腺癌、甲状腺癌常见，60%来源于肺癌、乳腺癌和前列腺癌[3]。这与脊柱有较为丰富的红骨髓以及特殊的无瓣膜静脉丛有关。脊椎静脉血流较缓慢，与肺、乳腺、盆腔、胃肠道等器官存在广泛潜在的???系。脊柱转移临床表现缺乏特异性，影像学检查是主要诊断方法。 　　3.1 X线平片 骨转移在X线平片上表现为溶骨型、成骨型和混合型3种。普通X线检查由于速度快、成本低、有较高的空间分别率等优势而在临床上得到广泛应用。但在骨转移检查过程中，这种方式敏感性较低，往往无法显示早期病变，对椎旁软组织和侵入椎管内的软组织病变显示困难。受图像重叠的影响，对一些深在的、较小的、组织结构重叠较多的部位的转移，甚至有的患者已经出现相应部位的症状，X线检查也可能不会有所发现。只有