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目的:比较分析CT与X线平片在诊断乳腺癌脊椎骨转移中的应用价值。方法:回顾分析2000年1月~2005年12月收治的乳腺癌脊椎转移83例中,在同一部位2周内分别行普通X线和CT检查,共232个部位。用随机双盲法由2名放射科医师对患者的CT及X线平片分别进行判读。结果:(1)乳腺癌脊柱骨转移好发部位由高到低依次为胸椎、腰椎、骶尾椎、颈椎;(2)CT对脊柱骨转移的诊断较X线平片准确、客观,CT诊断脊柱骨转移的准确率为74.6%,高于X线平片的50%;(3)X线平片诊断脊柱骨转移的准确率有随周围结构程度提高,准确率降低的趋势,在对附件转移、转移瘤是否侵及软组织和椎管的判定方面不如CT。结论:当临床诊断和X线平片诊断结果不一致时,应考虑进一步行CT检查;在怀疑椎体附件或椎管有病变侵及时,应尽早行CT或MRI检查。
Objective: To compare the value of CT and X-ray in the diagnosis of spine bone metastasis of breast cancer. Methods: A retrospective analysis of 83 cases of spondylolisthesis of breast cancer from January 2000 to December 2005 were performed, and X-ray and CT examinations were performed in the same site within 2 weeks respectively, a total of 232 sites. Randomized double-blind method by two radiologists in patients with CT and plain radiographs were interpreted. Results: (1) The descending order of the incidence of spine bone metastasis in breast cancer was thoracic, lumbar, sacrococcygeal and cervical vertebra from high to low; (2) The CT diagnosis of spine bone metastasis was more accurate and objective than CT The accuracy of spine bone metastasis was 74.6%, which was higher than 50% of X-ray plain radiographs. (3) The accuracy of X-ray film diagnosis of spine bone metastasis increased with the degree of surrounding structure and the accuracy decreased. Metastasis, metastases and invasion of soft tissue and spinal canal is not as good as CT. Conclusion: When the diagnostic results of X-ray and plain radiographs are inconsistent, further CT examination should be considered. CT or MRI should be performed as soon as possible when there is suspected invasion of vertebral attachment or spinal canal.