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目的:分析前列腺癌骨转移患者99Tcm-MDP骨扫描病灶特点。方法 :306例前列腺癌患者均行99Tcm-MDP骨扫描,骨扫描不能确诊骨转移时再经CT、MRI和病理及临床随访等进一步确诊有无骨转移。结果:306例前列腺癌患者中,99Tcm-MDP骨扫描阳性病例数为183例,最终确诊骨转移者129例;阴性病例数为123例,最终7例确诊为骨转移。最终经CT、MRI和病理及临床随访等明确骨转移者总计136例,占44.44%。在136例骨转移患者中,99Tcm-MDP骨扫描诊断骨转移Ⅰ级病例数为59例,Ⅱ级病例数为31例,Ⅲ级病例数为46例。99Tcm-MDP骨扫描诊断骨转移总病灶数为648个,其中骨盆骨转移病灶数为197个(占30.40%);脊柱骨转移病灶数为163个(占25.15%);肋骨转移病灶数为125个(占19.29%);四肢骨转移病灶数为79个(占12.19%),其中股骨近端最常见为57个(占四肢骨的72.15%);胸骨转移病灶数为49个(占7.56%);颅骨及其他骨转移病灶数为35个(占5.40%)。结论:99Tcm-MDP骨扫描是诊断前列腺癌骨转移分级的首选检查方法,前列腺癌易发生骨转移的病变部位依次为骨盆、脊柱、肋骨、股骨近端。
Objective: To analyze the features of 99Tcm-MDP bone scintigraphy in patients with prostate cancer with bone metastases. Methods: A total of 306 prostate cancer patients underwent 99Tcm-MDP bone scintigraphy. Bone metastasis was not confirmed when bone metastases were confirmed by CT, MRI, pathology and clinical follow-up. RESULTS: Among 306 prostate cancer patients, there were 183 cases of 99Tcm-MDP positive bone scans and 129 cases of final bone metastases. The number of negative cases was 123 cases and the final 7 cases were diagnosed as bone metastases. Finally by CT, MRI and pathology and clinical follow-up clear bone metastases such as a total of 136 cases, accounting for 44.44%. In 136 patients with bone metastases, 99 Tcm-MDP bone scan grade Ⅰ 59 cases of bone metastases, Ⅱ grade cases were 31 cases, Ⅲ grade cases were 46 cases. There were 648 bone metastases diagnosed by 99Tcm-MDP bone scintigraphy, of which 197 (30.40%) had pelvic bone metastases, 163 (25.15%) had spine bone metastases and 125 (Accounting for 19.29%); the number of bone metastases in limbs was 79 (12.19%), of which the proximal femur was 57 (72.15% of all extremities); the number of sternal metastases was 49 (accounting for 7.56% ); The number of skull and other bone metastases was 35 (5.40%). Conclusion: 99Tcm-MDP bone scintigraphy is the first choice for the diagnosis of bone metastasis of prostate cancer. The pathological sites of bone metastasis of prostate cancer are pelvis, spine, rib and proximal femur.