【摘要】 目的 探讨MRI与SPECT对脊柱良恶性病变，特别是骨转移的诊断与鉴别诊断价值。方法 选择同一时间段(1个月)内先后接受MRI及SPECT检查的脊柱转移病例33例、良性病变16例进行对比分析。其中5例经手术病理证实，其余经临床及随访证实。统计学处理采用χ2检验。结果 在MRI表现上，脊柱恶性病变常可见到椎体附件受累、受累椎体的膨胀性改变及合并椎旁软组织肿块；而良性感染性病变则可见到伴随的椎旁脓肿或蜂窝织炎样改变以及椎间盘的广泛受累。在与SPECT的对照方面，MRI在发现脊柱病灶及对病灶的定性上均优于SPECT。结论 脊柱转移的MRI表现较具特征性。MRI对脊柱转移诊断的敏感性及准确率均优于SPECT，但由于后者在一次成像中可显示全身骨骼的代谢情况，便于整体评价全身骨病变，因此在骨转移的筛查中仍发挥着重要作用。

    【关键词】 脊柱；转移；诊断；鉴别诊断；磁共振成像；单光子发射计算机断层扫描系统

    The value of MRI in the diagnosis and differential diagnosis of spinal metastasis(comparison with SPECT)

    LIU Feng-li,LI Shan-chun,SU Xu-qing,et al.

    Imaging Center,The Affiliated Yantai Yuhuangding Hospital of Qingdao University of Medical College,Yantai 264000,China

    【Abstract】 Objective To investigate the value of MRI and SPECT in the diagnosis and differential diagnosis of benign and malignant spinal lesions,especially the bone metastasis.Methods 33 cases of spinal metastasis and 16 cases of benign spinal lesions that underwent MRI and SPECT examinations sequentially in a short time of interval (within a month) were included in the study.The imaging data were retrospectively analyzed and compared.Among them,the diagnosis were confirmed by surgical operation and pathology in 5 cases;and the others confirmed by clinical data and follow-up.Chi Square Test was used for statistical analysis.Results The MRI manifestations included the involvement of vertebral appendix,the expansion of the involved portion and the paravertebral soft tissue mass;while in benign infectious lesions,paravertebral abscess or phlegmon as well as massive involvement of the intervertebral disc were often present.In comparison with SPECT,MRI was better in both the detection and discrimination of the vertebral lesions.Conclusion The MRI manifestations of spinal metastasis are relatively characteristic.Both the sensitivity and accuracy rate of MRI in the diagnosis of spinal metastasis are better than that of SPECT.But on the other hand,SPECT can reveal hole-body skeleton metabolic conditions in a single imaging process,so it still play an important role in the clinical screening for bone metastasis. ......