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目的:总结探讨囊状膨胀型骨转移瘤X线诊断临床特点。材料与方法:选择2004年1月~2013年12月期间我院收治的40例囊状膨胀型骨转移瘤患者为研究对象,总结分析其临床X线诊断特点。结果:40例患者原发瘤包括9例肺癌、7例鼻咽癌、6例肾癌、4例乳腺癌、3例甲状腺癌、3例食管癌、3例肝癌、1例结肠癌,4例不明转移性癌。X线诊断:40例患者中29为单发,11例为多发。其中18例发生于四肢长管状骨、6例发生于椎体、5例发生于肋骨、4例发生于骨盆、3例发生于肩胛骨、2例发生于锁骨、2例发生于颅骨。17例单纯囊状破坏,15例囊状破坏伴轻度膨胀,8例囊状破坏伴明显膨胀。30例患者病变边缘清晰,10例边缘模糊。14例骨皮质破坏、断裂,10例边缘有硬化,5例病灶内见粗细不一网格状骨梁影和散在斑点状钙化。伴有4例病理性骨折,3例截瘫。40例患者都有不同程度软组织肿胀,其中7例扪及软组织肿块。结论:囊状膨胀型骨转移瘤多发生在原发瘤1~11年间,与原发瘤细胞的分化程度及发展快慢等有密切关系。
Objective: To summarize the clinical features of X-ray diagnosis of cystic swollen bone metastases. MATERIALS AND METHODS: Forty patients with cystic metastases of bone metastases treated in our hospital from January 2004 to December 2013 were selected as the study objects, and the clinical features of X-ray diagnosis were summarized. Results: The primary tumor of 40 patients included 9 cases of lung cancer, 7 cases of nasopharyngeal carcinoma, 6 cases of renal carcinoma, 4 cases of breast cancer, 3 cases of thyroid cancer, 3 cases of esophageal cancer, 3 cases of liver cancer, 1 case of colon cancer and 4 cases Unknown metastatic cancer. X-ray diagnosis: 40 patients in 29 single, 11 cases of multiple. Of these, 18 occurred in long, tubular bones of the limbs, 6 in the vertebral body, 5 in the ribs, 4 in the pelvis, 3 in the scapula, 2 in the clavicle and 2 in the skull. 17 cases of simple cystic destruction, 15 cases of cystic destruction with mild swelling, 8 cases of cystic destruction with significant expansion. 30 patients with clear edge of the disease, 10 cases of fuzzy edges. 14 cases of cortical bone destruction, fracture, 10 cases of edge of the sclerosis, 5 lesions see the thickness of the mesh-like bone beam shadow and scattered in the plaque calcification. With 4 cases of pathological fracture, 3 cases of paraplegia. All 40 patients had varying degrees of soft tissue swelling, of which 7 cases palpable soft tissue mass. Conclusion: Cystic intumescent bone metastases occur mostly in primary tumors for 1 to 11 years, which are closely related to the differentiation and development of primary tumor cells.