Bildgebende Diagnostik bei Skelettmetastasen

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• 作者：L. Kintzelé ; M.-A. Weber
• 关键词：SchlüsselwörterKnochenläsion ; Knochenstabilität ; Knochenstoffwechsel ; Wirbelkörperfraktur ; Therapieüberwachung
• 刊名：Der Radiologe
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：57
• 期：2
• 页码：113-128
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Imaging / Radiology; General Practice / Family Medicine;
• 出版者：Springer Medizin
• ISSN：1432-2102
• 卷排序：57

文摘

Bone metastases are common, can cause a variety of relevant symptoms and are often associated with a poor prognosis. An early and accurate diagnosis is therefore crucial; however, the pattern is very heterogeneous and necessitates good knowledge of the possibilities and limitations of each imaging modality. Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET/CT) have the highest sensitivity and specificity for detecting bone metastases. Gradient echo and diffusion-weighted sequences are valuable supplements to the MRI protocol in doubtful cases and MRI is particularly suitable for distinguishing osteoporotic from metastatic spinal fractures with a high degree of diagnostic certainty; however, CT is the modality of choice for stability assessment. Reliable imaging parameters to predict therapy response in cases of bone metastases have not yet been elucidated in large clinical trials. The PET/MRI approach has shown promising preliminary results for diagnosis of bone metastases and further studies in larger cohorts are the subject of ongoing studies.