Department of Radiology, Harvard Medical School, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
Diagn Interv Radiol. 2012 Jul-Aug;18(4):391-6. doi: 10.4261/1305-3825.DIR.5179-11.1. Epub 2012 Mar 9.
To determine the prevalence and imaging features of bone metastases in patients with gastrointestinal stromal tumors (GISTs).
The medical records of 190 patients with pathologically proven GISTs were reviewed, and patients with bone metastases were identified. Computed tomography (CT) scans of the chest, abdomen, and pelvis were examined for features of bone metastases, and findings were correlated with the results of positron-emission tomography (PET) and histopathology.
Of 190 GIST patients, six (3.2%) had bone metastases: four patients had multiple bone metastases, and two patients had a solitary metastasis. The maximum diameter of the metastases ranged from 2 to 40 mm, and they most commonly involved the vertebrae, ribs, pelvic bones, and femurs. All lesions were well-marginated and lytic. A soft tissue component was identified in three patients. The bone metastases showed intense fluorine-18 fluorodeoxyglucose (FDG) uptake. After treatment with imatinib mesylate in three patients, the bone metastases developed peripheral sclerosis on CT and became less FDG-avid on PET. All six primary tumors were morphologically high-grade with high mitotic rates and necrosis.
Bone metastases from GISTs are uncommon; when detected with CT, they are characterized by single or multiple lytic lesions with or without soft tissue involvement. A sclerotic rim may appear around the metastatic lesions in response to treatment. Similar to the disease in other sites, bone metastases show intense FDG uptake, which decreases following treatment.
确定胃肠道间质瘤（GIST）患者中骨转移的发生率和影像学特征。
回顾了 190 例经病理证实的 GIST 患者的病历，确定了有骨转移的患者。对患者的胸部、腹部和骨盆 CT 扫描进行了骨转移特征检查，并将检查结果与正电子发射断层扫描（PET）和组织病理学结果进行了相关分析。
在 190 例 GIST 患者中，有 6 例（3.2%）发生了骨转移：4 例患者有多发骨转移，2 例患者有单发转移。转移灶的最大直径范围为 2 至 40mm，最常累及椎体、肋骨、骨盆和股骨。所有病变边界清楚，呈溶骨性。3 例患者中发现有软组织成分。骨转移灶在氟-18 氟代脱氧葡萄糖（FDG）摄取方面表现出强烈的摄取。在 3 例患者接受甲磺酸伊马替尼治疗后，骨转移灶在 CT 上出现了周边硬化，在 PET 上 FDG 摄取减少。6 例原发性肿瘤在形态上均为高级别，有较高的有丝分裂率和坏死。
GIST 发生骨转移并不常见；当通过 CT 检测到骨转移时，其特征为单发或多发溶骨性病变，伴或不伴有软组织受累。转移性病变周围可能出现硬化环。与其他部位的疾病一样，骨转移灶在 FDG 摄取方面表现出强烈的摄取，在治疗后会减少。
