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目的 :提高对核素骨显像不典型病灶的诊断准确性。方法 :对 1 2 4例核素骨显像呈不典型病灶的骨病患者 ,分别进行病理活检 (手术或穿刺 ) ,定期复查核素骨显像或 X线、CT、MRI检查。结果 :1确诊为骨转移瘤 61例 ( 4 9.2 % ) ,原发性骨肿瘤 1 7例 ( 1 3.7% ) ,骨关节病 2 9例 ( 2 3.4% ) ,骨创伤 9例 ( 7.3% ) ,骨结核 5例 ( 4 .0 % ) ,骨炎症 3例 ( 2 .4% )。2就不典型病灶分布 :骨转移瘤中脊椎 5 2 .7% ,骨盆 2 3.1 % ,胸部 1 4.3% ,四肢 7.7% ,颅骨 2 .2 % ,各组之间差异有显著性 ;原发性骨肿瘤中四肢 71 .4% ,脊椎 1 4.3% ,骨盆 9.5 % ,胸部 4.8% ,各组之间差异有显著性 ;骨关节病中脊椎 5 1 .4% ,四肢 2 7.0 % ,胸部 1 6.2 % ,骨盆 5 .4% ,各组之间差异有显著性。结论 :核素骨显像表现为不典型病灶时首先考虑骨肿瘤 ;发生在颈、腰椎和膝关节处的老年患者以骨关节病为多 ;有骨创伤史者要考虑骨创伤可能 ,骨结核和炎症虽为少数也需与肿瘤鉴别。
Objective: To improve the diagnostic accuracy of radionuclide bone imaging atypical lesions. Methods: One hundred and twenty-four patients with atypical lesions of radionuclide bone imaging were examined by pathological biopsy (operation or puncture), radiographic examination by bone marrow biopsy or X-ray, CT and MRI. Results: 1 cases were diagnosed as bone metastases in 61 cases (4 9.2%), primary bone tumors in 17 cases (13.7%), osteoarthritis in 29 cases (23.4%) and bone trauma in 9 cases (7.3%). , 5 cases of bone tuberculosis (4.0%), 3 cases of bone inflammation (2.4%). 2 on the distribution of atypical lesions: bone metastases spine 52.7%, pelvis 2 3.1%, chest 4.3%, 7.7% limbs, skull 2.2%, the difference between the groups was significant; primary In the bone tumors, 71.4% of the limbs, 1.43% of the spine, 9.5% of the pelvis and 4.8% of the chest had significant differences between the groups. In the osteoarthrosis patients, 51.4% of the spine, 7.0% of the extremities and 1 6.2 of the chest %, Pelvis 5.4%, the difference between the groups was significant. CONCLUSIONS: Radionuclide bone imaging is first considered in atypical lesions of bone tumors. In elderly patients with cervical, lumbar and knee joints, there is more osteoarthrosis. Those who have history of bone trauma should consider the possibility of bone trauma, bone tuberculosis Although inflammation and a few also need to identify with the tumor.