儿童恶性肿瘤股骨转移的骨显像和MRI比较  

The comparative study of bone imaging and MRI on femoral bone metastases in children

作　　者：邵虹[1] 李玉华[1] 吴靖川[1] 施美华[1] 王谦[1] 王静蕾[1] 张弘[1] 林毅[1] 朱铭[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心影像诊断中心,200127

出　　处：《中华核医学杂志》2006年第3期156-157,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的比较骨显像和 MRI 在儿童恶性肿瘤股骨转移中的应用价值。方法对经病理检查确诊的25例恶性肿瘤患儿(神经母细胞瘤12例,淋巴瘤8例,原始神经外胚层肿瘤2例,横纹肌肉瘤3例)分别行全身骨显像和双侧股骨 MRI,MRI 采用自旋回波 T_1WI 及短时反转恢复(STIR)序列冠状面成像。结果 12例神经母细胞瘤患儿中骨显像阳性7例,可疑2例,阴性3例,7例阳性、2例可疑及1例阴性病例 MRI 检查均阳性;8例淋巴瘤骨显像阳性5例,阴性3例,5例阳性及2例阴性患儿 MRI 阳性;2例原始神经外胚层肿瘤骨显像与 MRI 均阳性;3例横纹肌肉瘤骨显像阳性2例,阴性1例,MRI 均阳性。此外,MRI 发现股骨的异常信号范围大于骨显像。结论在儿童恶性肿瘤骨转移中联合应用骨显像和 MRI 有助于尽早诊断及提高诊断准确性。Objective To compare the application of bone imaging and MRI in the detection of femoral infiltration of children＇s malignant tumors. Methods Whole body bone imaging and femoral MRI examination were performed for twenty-five patients with histologically confirmed femoral bone metastases including 12 neuroblastomas, 8 lymphomas, 2 primitive neuroectodermal tumors （PNETs） and 3 rhabdomyosarcoma. In MRI T1-weighted and short tan inversion recovery（STIR） sequences coronal planes were reconstructed . Results In 12 neuroblastomas bone imaging showed 7 positive, 2 equivocal, 3 negative. Except 2 negative bone imaging cases all 10 patients presented positive on MRI. Among 8 lymphomas, 5 were positive and 1 was negative on both bone imaging and MRI, the other 2 were negative on bone imaging but positive on MRI. Two PNETs presented positive on both bone imaging and MRI. Three rhabdomyosareoma showed 2 positive and 1 negative on bone imaging, whereas both positive on MRI. The lesions detected by MRI were larger than those found by bone imaging. Conclusions Although MRI is more sensitive than bone imaging in the detection of femoral bone metastases in children; it is hard to find some skeletal lesions. Therefore, combined application of bone imaging with MRI may be helpful for the early and accurate diagnoses for some patients.

关 键 词：股骨肿瘤 肿瘤转移 放射性核素显像 MDP 磁共振成像 儿童 

分 类 号：R730.4[医药卫生—肿瘤]