上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1059-.doi: 10.3969/j.issn.1674-8115.2010.09.010

• 专题报道（影像医学与核医学） • 上一篇    下一篇

分化型甲状腺癌骨转移的临床特点及影像学诊断分析

邱忠领, 许艳红, 宋红俊, 陈立波, 朱瑞森, 陆汉魁, 罗全勇   

  1. 上海交通大学 第六人民医院核医学科, 上海 200233
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 通讯作者: 罗全勇, 电子信箱: lqyn@sh163.net。
  • 作者简介:邱忠领（1980—）, 男, 住院医师, 硕士；电子信箱: qiuzhongling123@163.com。

Clinical features and imaging diagnosis of bone metastases from differentiated thyroid cancer

QIU Zhong-ling, XU Yan-hong, SONG Hong-jun, CHEN Li-bo, ZHU Rui-sen, LU Han-kui, LUO Quan-yong   

  1. Department of Nuclear Medicine, The Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, |China
  • Online:2010-09-25 Published:2010-09-27

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摘要：

目的 探讨分化型甲状腺癌（DTC）骨转移的临床特征和影像学诊断。方法 回顾性分析106例经131I治疗的DTC骨转移患者的发生率、发病年龄、临床症状、体征、病理类型、转移部位及合并其他转移的情况，并对131I 全身扫描、99mTc-MDP骨扫描、MRI、X线和CT诊断DTC骨转移敏感性进行比较，总结其临床特征。结果骨转移发生率约占DTC患者的8.43%（106/1258），好发部位以肋骨、髂骨和胸椎居多，以溶骨性骨转移为主；以骨转移为首发症状的DTC患者占19.81%；多发性骨转移多见。MRI、131I扫描、CT、X线、和99mTc-MDP骨扫描诊断甲状腺癌骨转移的敏感性依次为96.59%、93.84%、66.49%47.46%和38.19%，其中131I全身扫描与X线、CT和99mTc-MDP检查比较差异有统计学意义（P＜0.05）；131I全身扫描与MRI检查比较差异无统计学意义（P＞0.05）。结论 骨转移以多发性溶骨性病变为主，MRI和131I全身扫描的敏感性较高，CT次之，全身骨扫描和X线的敏感性较低。

关键词: 分化型甲状腺癌, 骨转移, 放射性碘

Abstract:

Objective To investigate the clinical features and imaging diagnosis of bone metastases from differentiated thyroid cancer (DTC). Methods The rate of bone metastases, age, clinical symptoms and signs, pathological types, metastatic sites and other concomitant metastases of 106 patients with bone metastases from DTC treated by 131I were retrospectively analysed. The sensitivities of MRI, 131I whole body scan, X-ray, CT and 99mTc-MDP bone scan in the detection of bone metastases from DTC were compared. Results The rate of bone metastases was 8.43%(106/1 258), and most of the bone metastases were osteolytic lesions. Ribs, ilia and thoracic vertebrates were the most common sites of bone metastases from DTC. Bone metastases served as the initial presentation in 19.81% of patients, and multiple bone metastases were commonly occurred. The sensitivities of MRI, 131I scan, CT, X-ray and 99mTc-MDP bone scan in the diagnosis of bone metastases were 96.59%, 93.84%, 66.49%, 47.46% and 38.19%, respectively, and there were significant difference in sensitivities between 131I scan and X-ray, CT and 99mTc-MDP bone scan (P＜0.05）. Conclusion Bone metastases from DTC are characterized by multiple osteolytic lesions. MRI and 131I whole body scan are more sensitive in the diagnosis of bone metastases form DTC than CT, 99mTc-MDP bone scan or X-ray.

Key words: differentiated thyroid cancer, bone metastasis, radioiodine