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目的总结前列腺癌脊椎骨转移的影像学变化特点,了解不同影像检查方法的优越点。方法收集75例全身骨静态扫描(ECT)检查有阳性表现的40~80岁的前列腺癌脊椎骨转移患者,追查其中进行过CT或MRI全脊椎检查的病例60例,观察三种检查方法在前列腺癌脊椎骨转移的不同影像学表现,比较三种方法诊断前列腺癌脊椎转移的敏感性。结果 1 60例CT和MRI显像后的骨质改变表现:呈成骨性破坏者48例80.0%,溶骨性破坏者有7例(11.7%),兼有溶骨及成骨破坏者病例5例(8.3%)。2 CT检查28例,阳性13例,敏感度为46.4%,假阴性率53.6%。相同照射野中,ECT比CT多检出12个病灶。3 MRI检查32病例中,阳性30例,敏感度为93.75%,假阴性率为6.25%。相同照射野中,MRI比ECT多检出15个病灶。结论 MRI对前列腺癌脊椎骨转移的发现敏感度高,而CT检查在临床诊断前列腺脊椎骨转移中表现出良好的作用。因此,在通过临床观察和ECT检查严重怀疑患者患有前列腺脊椎骨转移是,建议选用MRI进行全方位检查。
Objective To summarize the imaging features of spine bone metastasis of prostate cancer and to understand the superiority of different imaging methods. Methods Seventy-five patients with spine bone metastasis of prostate cancer aged 40 to 80 who had a positive examination by whole-body bone scintigraphy (ECT) were enrolled in the study. Sixty cases of CT scan or MRI were followed up. Vertebral metastases by different imaging findings, the three methods to compare the sensitivity of prostate cancer diagnosis of spinal metastases. Results Sixty cases of osteoporosis after CT and MRI imaging showed that 80 cases were osteogenic destroyer and 7 cases were osteolytic destroyer (11.7%), both osteolytic and osteogenic cases 5 cases (8.3%). 2 CT examination in 28 cases, 13 cases were positive, the sensitivity was 46.4%, the false negative rate was 53.6%. In the same irradiation field, ECT detected 12 lesions more than CT. 3 MRI examination of 32 cases, 30 were positive, the sensitivity was 93.75%, false negative rate was 6.25%. In the same irradiation field, MRI detected more than 15 lesions in ECT. Conclusion MRI is highly sensitive to the detection of spondylolisthesis in prostate cancer, while CT examination has a good effect on the clinical diagnosis of prostate spine bone metastasis. Therefore, it is recommended that MRI be used to conduct a full range of examinations in patients who are seriously suspected to have prostate spine metastases through clinical observation and ECT.