单发肋骨转移的SPECT和CT影像学表现  

SPECT and CT Imaging Manifestations of Single Rib Metastasis

作　　者：薛倩倩 林择方 陈少明[1] 林军[1] 缪蔚冰[1,2] XUE Qianqian;LIN Zefang;CHEN Shaoming;LIN Jun;MIAO Weibing(Nuclear Medicine Department, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China;Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院核医学科,福州350005 [2]福建医科大学附属第一医院福建省肿瘤精准诊疗重点实验室,福州350005

出　　处：《福建医科大学学报》2021年第5期458-463,共6页Journal of Fujian Medical University

基　　金：福建省自然科学基金项目(2019J01454)。

摘　　要：目的分析单发肋骨转移的SPECT和CT影像学表现。方法收集因骨外原发恶性肿瘤行全身骨显像的患者290例,其全身骨显像均表现为单发肋骨放射性浓聚,相应肋骨放射性浓聚灶行局部SPECT/CT断层显像或同期胸部CT扫描,对肋骨病变进行随访确定其性质。结果290例中,肋骨病变诊断明确的有238例(骨转移25例,良性病变213例),病变性质待定52例。条状病变转移率(42.42%,14/33)显著高于点状病变(5.36%,11/205),差别有统计学意义(χ^(2)=41.524,P<0.001);后肋转移率(18.46%,12/65)显著高于前肋(6.20%,8/129),差别有统计学意义(χ^(2)=7.026,P=0.008);侧肋转移率(11.63%,5/43)高于前肋(6.20%,8/129),而低于后肋(18.46%,12/65),但差别均无统计学意义(χ^(2)=1.359,P=0.244;χ^(2)=0.911,P=0.340)。25例骨转移患者中,CT表现阴性1例(4.00%),溶骨型转移20例(80.00%),混合型转移4例(16.00%)。结论后肋、条状分布的单发肋骨放射性浓聚灶转移率相对更高,单发肋骨转移以溶骨型相对多见。Objective To analyze the SPECT and CT imaging manifestations of single rib metastasis.Methods 290 patients with extra-skeletal malignancy presenting single rib hot spots on bone scan were collected.The SPECT and CT imaging manifestation were analyzed.Results 238 patients had established cause of the single rib hot spots,while 52 patients had not established the cause.Out of 238 patients,25(10.50%)patients had a single rib metastasis and 213(89.50%)patients had a single benign rib hot spots.The incidence of metastasis in strip-type rib hot spots(42.42%,14/33)was significantly higher than that in ovoid rib hot spots(5.36%,11/205,χ^(2)=41.524,P<0.001).The incidence of metastasis in the posterior rib hot spots(18.46%,12/65)was significantly higher than that in the anterior rib hot spots(6.20%,8/129,χ^(2)=7.026,P=0.008).No differences were observed when we compared the incidence of metastasis in the lateral rib hot spots(11.63%,5/43)with that in the anterior rib hot spots or with that in the posterior rib hot spots(χ^(2)=1.359,P=0.244;χ^(2)=0.911,P=0.340).Among the 25 rib metastasis,20(80.00%)rib metastasis were osteolytic metastasis and 4(16.00%)rib metastasis were mixed bone metastasis.The CT manifestation was negative in one rib metastases.Conclusion The incidence of metastasis is high in the posterior and strip-type single rib hot spots.Single rib metastasis manifest mainly osteolytic metastasis.

关 键 词：SPECT/CT 肋骨 转移 单发 

分 类 号：R73[医药卫生—肿瘤]