核素骨显像与 X 线平片对肺癌骨转移的诊断价值  

DIAGNONSTIC VALUE OF RADIONUCLIDE BONE IMAGING AND X RAY FILM FOR BONE METASTASIS OF LUNG CANCER

作　　者：李雨升[1] 刘建滨[1] 徐德永[1] 王国明[1] 左书耀[1] 孙建文[1] 

机构地区：[1]青岛医学院附属医院核医学科

出　　处：《青岛医学院学报》1997年第1期50-51,共2页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的探讨核素骨显像与Ｘ线平片对肺癌骨转移的诊断价值。②方法对８２例肺癌病人分别进行９９ｍＴｃ－ＭＤＰ骨显像及Ｘ线平片检查。③结果核素骨显像阳性者５５例（６０．０７％），检出骨转移病灶１２４个；骨Ｘ线平片阳性者３４例（４１．４６％），检出骨转移病灶４９个。两种方法阳性检出率相比较差异有显著性（χ２＝９．９１，Ｐ＜０．０１）。在３４例骨Ｘ线平片阳性者中，有４例骨显像为阴性，示骨显像假阴性为１１．７６％．对２１例骨显像阳性而Ｘ线平片阴性病人的随访结果表明，从骨显像阳性至骨Ｘ线平片示该部位骨质异常改变的最早期限为９６ｄ，最迟为２４０ｄ，中位数为１３５ｄ．④结论骨显像有早期诊断肺癌骨转移灶的价值。两种方法结合应用对肺癌骨转移的诊断有互补作用，可以提高诊断率。Objective To study the diagnostic value of radionuclide bone imaging and plane X ray bone imaging for bone metastasis of lung cancer. Methods Eighty two lung cancer patients were examined with both 99m Tc MDP bone imaging and plane X ray film. Results One hundred and twenty four bone metastasis foci in 55 patients were observed by radionuclide bone imaging method. The positive rate was 60.07%. The plane X ray film method showed 49 bone metastasis foci in 34 patients. The posivive rate was 41.46%. The difference of the positive rate was significant( χ 2=9.91,P <0 01) between the two methods. Four patients showed negative results with radionuclide imaging among 34 patients who were positive with the X ray film. The false negative rate of radionuclide bone imaging was 11.76%. Follow up study of 21 patients who were diagnosed positive with radionuclide bone imaging and negative with X ray film showed that the time when radionuclide bone imaging positive foci could be diagnosed positive by X ray film in these patients was 96 to 240 days, averaging 135 days. Conclusions Radionuclide bone imaging can show the bone metastasis in lung cancer patients earlier than the X ray film. Combining of the two methods is useful for improving accuracy of the diagnosis.

关 键 词：肺肿瘤 骨转移 X线诊断 放射线核素显像 

分 类 号：R734.204[医药卫生—肿瘤] R738.104[医药卫生—临床医学]