肺癌椎体转移瘤影像学特征与原发灶组织学的相关性研究  

Study on the Correlation between Imaging Examination and Primary His⁃tology of Vertebral Metastases of Lung Cancer

作　　者：魏巍 崔伟 赵龙 王思曼 王静 李聪智 史福平[4] WEI Wei;CUI Wei;ZHAO Long;WANG Siman;WANG Jing;LI Congzhi;SHI Fuping(Department of Radiology,Hebei Third Rongjun Youfu Hospital,Baoding,Hebei 071000,China;Department of Affective Disorders,1.Hebei Third Rongjun Youfu Hospital,Baoding,Hebei 071000,China;Department of Medical Imaging,82nd Army Group Hospital,Baoding,Hebei 071000,China;Depart-ment of Neurology,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China)

机构地区：[1]河北省第三荣军优抚医院放射科,河北保定071000 [2]河北省第三荣军优抚医院情感障碍科,河北保定071000 [3]陆军第八十二集团军医院医学影像科,河北保定071000 [4]河北大学附属医院神经内科,河北保定071000

出　　处：《临床误诊误治》2024年第9期45-52,共8页Clinical Misdiagnosis & Mistherapy

基　　金：保定市科技计划项目(2141ZF327)。

摘　　要：目的 探讨肺癌椎体转移瘤患者CT、MRI影像特征与原发灶组织学类型的关系。方法 回顾性分析2019年1月-2022年12月收治的103例肺癌椎体转移瘤临床资料,其中腺癌37例、鳞癌31例、小细胞癌19例、大细胞癌16例,分析CT、MRI特征与原发灶组织学类型的关系。结果 103例肺癌椎体转移瘤受累椎体以胸椎多见(65例,63.11%),37例(35.92%)单节段转移,23例(22.33%)双节段转移,43例(41.75%)多节段转移。原发灶不同组织学类型患者椎体转移瘤部位、受累节段、椎体骨折、椎管受累、椎旁肿物、常规MRI信号表现、增强MRI强化特点、椎间盘膨出、腰椎退行性病变情况比较差异无统计学意义(P>0.05);鳞癌骨质改变类型以混合型为主,腺癌骨质改变类型以溶骨型、成骨型为主,鳞癌与腺癌骨质改变类型比较差异有统计学意义(P<0.05);小细胞癌出现脊髓受压、其他脏器转移患者多于腺癌、鳞癌、大细胞癌(P<0.05);腺癌、鳞癌有胸腔积液患者多于小细胞癌、大细胞癌(P<0.05)。结论 骨质改变类型、脊髓受压、其他脏器转移、胸腔积液情况与肺癌椎体转移患者原发灶组织学类型有关,腺癌和鳞癌患者更易发生椎体转移,采用CT、MRI检查可相互弥补,准确识别以上特征,可为临床判断原发灶组织学类型、筛选肺癌椎体转移高风险人群等提供参考。Objective To investigate the relationship between CT and MRI imaging characteristics and histological types of primary lesions in patients with vertebral metastases of lung cancer.Methods The clinical data of 103 patients with vertebral metastases of lung cancer treated from January 2019 to December 2022 were retrospectively analyzed,including 37 patients with adenocarcinoma,31 patients with squamous cell carcinoma,19 patients with small cell carcinoma and 16 patients with large cell carcinoma.The relationship between CT and MRI characteristics and histological types of primary lesions was analyzed.Results In 103 patients with vertebral metastases of lung cancer,most of the affected vertebrae were thoracic ver-tebrae(65 cases,63.11%),including 37(35.92%)patients with single-segment metastasis,23(22.33%)with double-segment metastasis,and 43(41.75%)with multi-segment metastasis.There was no significant difference in the location of vertebral metastases,affected segment,vertebral fracture,vertebral canal involvement,paravertebral mass,conventional MRI signal manifestations,enhanced MRI intensity features,disc bulging,and lumbar degenerative diseases among patients with different histological types of primary lesions(P>005).The main bone change types of squamous cell carcinoma were mixed type,and the main types of bone changes in adenocarcinoma were osteolytic type and osteoblastic type;the difference in the types of bone changes between squamous cell carcinoma and adenocarcinoma was statistically significant(P<005).There were more small cell carcinoma patients with spinal cord compression and metastasis to other organs than patients with adeno-carcinoma,squamous cell carcinoma and large cell carcinoma(P<005).More pleural effusion was found in patients with adenocarcinoma and patients with squamous cell carcinoma,as compared with those with small cell carcinoma and large cell carcinoma(P<005).Conclusion The type of bone change,spinal cord compression,metastasis to other organs and pleu-ral effusion are related to the

关 键 词：肺肿瘤 椎体转移 体层摄影术 螺旋计算机 磁共振成像 腺癌 鳞癌 小细胞癌 大细胞癌 

分 类 号：R734.2[医药卫生—肿瘤]