目的　分析脊柱溶骨性转移瘤的CT表现 ,探讨CT对该病的诊断及鉴别诊断价值。方法　分析 46例 72个椎骨溶骨性转移瘤的CT表现 ,并与其中 2 8例的X线平片结果进行比较。结果　 46例脊柱溶骨性转移瘤的 72个转移椎骨中 ,椎体破坏 45例共 74个病灶 ,椎弓根破坏 2 2例 ,累及横突 15例 ,椎板和棘突 (受累 )各 11例。微转移病灶集中在椎体 ( 4 5 /4 9)。CT发现骨破坏、椎管受累及椎旁软组织肿块分别为 10 0 %、67.85 %及 71.4% ,而X线对三者的发现率仅为 5 3 .6%、14 .3 %及 3 2 .1%。结论　脊柱转移瘤首先侵犯椎体 ,椎体转移瘤是椎弓根、椎板、横突和棘突破坏的基础。CT扫描在发现和评估病变方面较X线平片检查敏感 Objective To analyze the CT manifestations of osteolytic metastases of the spine and to explore the value of CT in the diagnosis and differential diagnosis of the disease. Methods The CT findings of 46 cases of 72 osteolytic metastatic vertebrae were analyzed and compared with those of 28 cases of X - ray plain film. Results Of 46 metastatic vertebrae of osteolytic metastases of the spine, there were 74 lesions of 45 cases with vertebral destruction, 22 cases of pedicle destruction, 15 cases of transverse processes involved, and 11 cases of lamina and spinous process involvement example. Micrometastases focus on the vertebral body (45/49). CT findings of bone destruction, spinal involvement and paravertebral soft tissue mass were 100%, 67.85% and 71.4%, respectively, while the incidence of X-ray findings was only 53.6%, 14.3% and 32% respectively. 1%. Conclusion Spinal metastases first invade the vertebral body, and vertebral metastases are the basis of the destruction of the pedicle, lamina, transverse processes and spinous processes. CT scans are more sensitive than plain radiographs in detecting and evaluating lesions