比较术前影像学检查与穿刺活检诊断四肢长骨巨细胞瘤的准确率

Comparison of preoperative diagnostic accuracy of needle biopsy and imaging examination for limb long bone giant cell tumor

目的对比观察术前影像学检查和经皮穿刺活检术诊断四肢长骨巨细胞瘤(GCT)的准确率,探讨影像学检查在术前诊断GCT中的作用。方法回顾性分析术后病理证实为GCT的89例患者,将术前穿刺活检(89例)、X线平片检查(89例)和MR检查(59例)的诊断结果与手术切除后最终病理结果进行比较。结果 89例中,穿刺活检病理正确诊断71例,X线平片正确诊断73例,其诊断准确率分别为79.78%(71/89)和82.02%(73/89);59例接受MR检查,结合X线平片正确诊断51例,其诊断准确率为86.44%(51/59)。穿刺活检与X线平片、MRI结合X线平片诊断GCT的准确率差异无统计学意义(χ2=1.09,P=0.58)。术前穿刺活检不能做出正确诊断的18例中,15例(15/18,83.33%)X线平片做出正确诊断。结论术前穿刺活检与影像学检查诊断四肢长骨GCT的准确率相似,二者相结合可提高术前诊断的正确率。

Objective To compare the preoperative diagnostic accuracy of needle biopsy and imaging examination for limb long bone giant cell tumor（GCT）,and to explore the value of imaging examination of this disease.Methods Eighty-nine patients with GCT of limb long bones confirmed by postoperative pathology were reviewed.Images were obtained with X ray（n=89） and MR scanning（n=59）.All patients underwent core needle biopsy.The diagnostic results of imaging and needle biopsy were compared with those of postoperative pathology.Results In 89 patients,the preoperative diagnostic accuracy of needle biopsy and X ray film was 79.78%（71/89） and 82.02%（73/89）,respectively.In 59 patients underwent MR,the preoperative diagnostic accuracy was 86.44%（51/59）.No significant difference of diagnostic accuracy was found among the three methods（χ2=1.09,P=0.58）.In 18 patients not diagnosed correctly by needle biopsy,15（15/18,83.33%） were diagnosed correctly with X ray film.Conclusion The preoperative diagnostic accuracy of limb long bone GCT is similar between needle biopsy and imaging examination.Combination of imaging examination is helpful to increasing the diagnostic accuracy of needle biopsy for limb long bone giant cell tumor.