Steinborn M, Tiling R, Heuck A, Brügel M, Stäbler A, Reiser M
Institut für Klinische Radiologie, Ludwig-Maximilians-Universität München, Klinikum Grosshadern.
Radiologe. 2000 Sep;40(9):826-34. doi: 10.1007/s001170050830.
MRI plays an important role in the diagnostic workup of skeletal metastases. In principle two different applications of MRI can be distinguished: apart from the well known indications of clarifying uncertain lesions seen with other imaging modalities or demonstrating known osseous lesions with high resolution imaging for therapeutic planing, MRI can also be used as a primary screening modality for skeletal metastases. Besides the higher lesion detection rate the major advantage of MRI compared to bone scintigraphy lies in the demonstration of morphology which on the one hand exactly shows the extension of tumorous lesions and on the other hand clearly distinguishes between malign and benign processes. As unclear findings on bone scintigraphy often require additional imaging studies, especially in patients with clinical findings or lab results suggestive for metastatic disease, we think that whole-body-skeletal-MRI is not only an accurate but also a cost effective diagnostic modality in the detection and screening for skeletal metastases, if the indication for the examination is closely related to clinical findings and the therapeutic relevance of the imaging results.
磁共振成像（MRI）在骨骼转移瘤的诊断检查中发挥着重要作用。原则上，MRI有两种不同的应用方式：除了用于明确其他成像方式发现的不确定病变，或通过高分辨率成像显示已知骨病变以进行治疗规划等众所周知的适应症外，MRI还可作为骨骼转移瘤的一种初步筛查方式。与骨闪烁显像相比，MRI除了具有更高的病变检出率外，其主要优势在于能够显示形态，一方面可准确显示肿瘤病变的范围，另一方面能清晰区分恶性和良性病变过程。由于骨闪烁显像的不明确结果通常需要额外的影像学检查，特别是在有临床症状或实验室结果提示转移性疾病的患者中，我们认为，如果检查适应症与临床症状以及成像结果的治疗相关性密切相关，全身骨骼MRI不仅是一种准确的，而且是一种具有成本效益的骨骼转移瘤检测和筛查诊断方式。
