影像学检查在骨肿瘤诊治中的应用价值

Value of Imaging Study in the Diagnosis of Bone Tumor

目的探讨骨肿瘤诊治中的影像学检查的价值。方法回顾性分析110例骨肿瘤患者的影像学及病理学资料。110例患者中102例行数字化X射线摄影(DR)检查,其中42例患者行计算机体层摄影术(CT)检查,40例患者行磁共振成像(MRI)检查,比较骨肿瘤的影像学特征,比较影像学与病理学诊断结果及对良恶性骨肿瘤的诊断正确率。结果 DR和CT在显示骨质增生、破坏、硬化和病灶边界等方面结果类似,但是DR在颅、脊柱、骨盆病灶、细微病灶、软组织阴影不如CT;DR在骨膜反应中表现良好,MRI在骨髓水肿和软组织的影响上特异性最强,但是在显示骨膜增生、硬化、破坏、钙化等方面情况较差。DR诊断的正确率为91.20%,CT诊断的正确率为90.48%,MRI诊断正确率为95.00%。3种影像学检查方法对良恶性骨肿瘤的鉴别诊断正确率方面没有统计学差异(P>0.05)。结论 DR平片为骨肿瘤的首选的检查方法,CT主要显示肿瘤的范围和细微结构,MRI对软组织及骨髓水肿具有一定的优势,三者相结合对骨肿瘤诊治过程中的判断具有优势互补的作用。

Objective To investigate the value of imaging study in the diagnosis of bone tumor. Methods The imaging and pathological data of 110 cases of bone tumor were retrospectively analyzed. Among 110 patients, 102 cases underwent digital X-ray radiography（DR） inspection, including 42 patients treated with computed tomography （CT） examination, and 40 patients treated with magnetic resonance imaging （MRI） examination, bone tumor imaging features were compared, and radiological and pathological diagnosis of benign and malignant bone tumors and diagnostic accuracy were compared. Results DR and CT had similar display in osteoarthritis, destruction,lesion boundary, such as hardening and results, but the DR was not as good as CT in skull, spine, pelvis lesions, minor lesions, soft tissue shadow, DR had good performance in periosteal reaction, MRI had the strongest specificity in the impact of bone marrow edema and soft tissue, but in the show periosteal proliferation, sclerosis, destruction, calcification and other aspects of the situation was worse. DR diagnostic accuracy was 91.20% , CT diagnostic accuracy was 90.48% ;MRI diagnostic accuracy was 95.00% ,there had no statistically significant difference in the diagnosis accuracy of benign and malignant bone tumors of the 3 imaging methods （ P 〉 0.05 ）. Conclusion The preferred method of examination is CR flat piece of bone tumors, CT primary display range and the fine structure of the tumor, MRI has certain advantages for soft tissues and bone marrow edema, the combination of 3 methods have complementary advantages in the diagnosis of bone tumor.