核素骨显像与MRI对骨转移癌的诊断比较

目的评价骨显像与MRI在诊断骨转移瘤中的价值。方法对64例可疑骨转移的恶性肿瘤患者行核素骨显像与MRI检查（两种检查间隔时间不超过2周），凡骨显像表现为明显的放射性聚集或缺损和（或）MRI的T1加权像表现为低信号强度且T2加权像表现为高低混杂或高信号强度和（或）骨质破坏的椎体均认为是肿瘤骨转移。结果核素骨显像能有效地检出全身骨转移癌灶；MRI对扫描范围内骨转移癌检出的病灶数高于核素骨显像；核素骨显像单发病灶有一定的假阳性（3／9），MRI单发病灶假阳性较少（0／7），但部分病例（3／7）经核素骨显像检查证实为多发骨转移；MRI能了解局部病灶的准确位置及周围软组织情况。结论核素骨显像较MRI能更有效地检出全身骨转移癌灶，是早期诊断转移癌的首选方法；MRI特异性更高，解剖定位明确，并能显示软组织病灶，两种检查方法相互结合，对骨转移的诊断和治疗有重要意义。

The comparation of skeletal scintigraphy and MRI in diasnosing bone metastasis

Objective To evaluate the values of skeletal scintigraphy and MRI in detecting osseous metastasis.Methods Skeletal scintigraphy and MRI were performed in sixty-four patients with suspicious bone metastasis malignant tumor;all patients underwent skeletal scintigrapghy and MRI examinations within two weeks.Metastatic foci were defined as lesions that showed aggravations/defections of bone tracer uptakes on serial scans,and/or low signal intensity on T1WI and/or high signal intensity on T2WI of MRI,and/or bone destruction.Results Planar skeletal scintigraphy could detect the whole body bone metastasis lesions more effectively;MRI discovered more metastasis lesions than planar skeletal scintigraphy in the range of the MRI scaned;certain amounts of false-positive cases might be present in single focal cases by skeletalscintigraphy(3/9).Relatively,MRI had less false-positive cases in single foci(0/7),but the three single foci cases detected by MRI were confirmed as multi-focal cases by skeletal scintigraphy.MRI can show the accurate position of the lesions and the situation of the soft tissue peripheral.Conclusions Skeletal scintigraphy is more efficient in detecting whole osseous metastasis foci than MRI;it is the first choice in osseous metastasis diagnosis.MRI has the higher specificity;it can show the dissection location and the soft tissue lesions clearly.The combination of the two inspection methods is very important to the diagnosis and treatment of osseous metastasis.