Study on the Correlation between Imaging Examination and Primary His-tology of Vertebral Metastases of Lung Cancer

WEI Wei; CUI Wei; ZHAO Long; WANG Siman; WANG Jing; LI Congzhi; SHI Fuping

doi:10.3969/j.issn.1002-3429.2024.09.010

Abstract：Objective To investigate the relationship between CT and MRI imaging characteristics and histological types of primary lesions in patients with vertebral metastases of lung cancer.Methods The clinical data of 103 patients with vertebral metastases of lung cancer treated from January 2019 to December 2022 were retrospectively analyzed,including 37 patients with adenocarcinoma,31 patients with squamous cell carcinoma,19 patients with small cell carcinoma and 16 patients with large cell carcinoma.The relationship between CT and MRI characteristics and histological types of primary lesions was analyzed.Results In 103 patients with vertebral metastases of lung cancer,most of the affected vertebrae were thoracic ver-tebrae(65 cases,63.11%),including 37(35.92%)patients with single-segment metastasis,23(22.33%)with double-segment metastasis,and 43(41.75%)with multi-segment metastasis.There was no significant difference in the location of vertebral metastases,affected segment,vertebral fracture,vertebral canal involvement,paravertebral mass,conventional MRI signal manifestations,enhanced MRI intensity features,disc bulging,and lumbar degenerative diseases among patients with different histological types of primary lesions(P＞0.05).The main bone change types of squamous cell carcinoma were mixed type,and the main types of bone changes in adenocarcinoma were osteolytic type and osteoblastic type;the difference in the types of bone changes between squamous cell carcinoma and adenocarcinoma was statistically significant(P＜0.05).There were more small cell carcinoma patients with spinal cord compression and metastasis to other organs than patients with adeno-carcinoma,squamous cell carcinoma and large cell carcinoma(P＜0.05).More pleural effusion was found in patients with adenocarcinoma and patients with squamous cell carcinoma,as compared with those with small cell carcinoma and large cell carcinoma(P＜0.05).Conclusion The type of bone change,spinal cord compression,metastasis to other organs and pleu-ral effusion are related to the histological type of primary lesions in patients with vertebral metastasis of lung cancer.Patients with adenocarcinoma and squamous cell carcinoma are more prone to vertebral metastasis.CT and MRI can supplement each other and accurately identify the above characteristics,thus providing reference for clinical judgment of histological type of pri-mary lesions and screening of high risk group of vertebral metastasis of lung cancer.