恶性骨肿瘤假体保肢术后的影像学监测研究  

Imaging Surveillance after Prosthesis Limb Salvage Surgery of Bone Cancer

作　　者：高俊雪[1] 韩敏[2] 车东东[1] 谢璐[3] 许婕[3] 朱家安[1] 李建国[1] 

机构地区：[1]北京大学人民医院超声科,北京市100044 [2]山东省济南市第四人民医院 [3]北京大学人民医院骨与软组织肿瘤治疗中心,北京市100044

出　　处：《中国超声医学杂志》2017年第1期68-71,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过对恶性骨肿瘤假体保肢术后病例进行局部影像学监测,探讨该病术后在超声影像学监测中的应用价值。方法对44例恶性骨肿瘤假体保肢术后病例进行定期(3个月)监测,均行超声、局部X线检查和^(99m)Tc-MDP全身骨扫描。超声检查部位包括原发病灶周围软组织、区域淋巴结、患侧肢体血管,复发病例中1例行MRI检查,1例行CT检查。结果超声发现9例局部复发,均经手术病理证实。其中1例局部复发,并腘窝淋巴结转移、腘静脉血栓,1例腓静脉及比目鱼肌静脉血栓。超声诊断局部复发或转移的灵敏度和特异度均高于X线检查和^(99m)Tc-MDP全身骨扫描,而MRI及CT受人工假体伪影干扰,对病灶的显示不够清晰。结论超声可用于恶性骨肿瘤假体保肢术后的局部影像学监测,为临床选择合理的干预措施提供依据。Objective To investigate the application value of ultrasonography in the imaging surveillance after prosthesis limb salvage surgery of bone cancer. Methods A regular （3 months） surveillance was performed on 44 cases with bone cancer after prosthesis limb salvage surgery and all of these cases underwent ultrasonography, X-ray and 99mTc-MDP bone scan. The ultrasound examination sites included the soft tissues, the regional lymph nodes,the peripheral vessels of the affected side. 1 of the recurrent cases underwent MRI, 1 of the recurrent cases underwent CT. Results 9 cases were found relapse through ultrasonography. All of these cases were confirmed by pathology. 1 case was found local relapse, popliteal lymph node metastasis and popliteal venous thrombosis, 1 case was found fibular vein and soleal vein thrombosis. The sensitivity and specificity of Ultrasonography for local relapse or metastasis were higher than the X-ray and 99mTc-MDP bone scan. The CT and MRI didn＇t display the lesions clearly enough because of the influence of the artifacts. Conclusions Color Doppler Ultrasonography can be used for the local imaging surveillance after prosthesis limb salvage surgery of bone cancer and provide a basis for reasonable interventions.

关 键 词：超声 恶性骨肿瘤 假体 监测 

分 类 号：R445[医药卫生—影像医学与核医学] R738[医药卫生—诊断学] R730.44[医药卫生—临床医学]