骨肿瘤影像学与病理学相关性研究

Diagnosis and Treatment of Bone Tumor Imaging and Pathological Correlation

目的探讨骨肿瘤影像学与病理学相关性研究。方法纳入确诊为骨肿瘤的患者50例,回顾性分析纳入患者的影像学及病理学资料,其中50例患者均行数字化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相近,但是DR在颅、脊柱、骨盆病灶、细微病灶、软组织阴影不如CT,DR对骨膜反应良好,MRI对骨髓水肿和软组织的特异性最强,但是在显示骨膜增生、硬化、破坏、钙化等方面情况较差。DR诊断正确率为88.0%,CT诊断正确率为90.5%;MRI诊断正确率为95.0%,3种影像学检查方法对良恶性骨肿瘤的诊断正确率比较无统计学差异(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的诊治具有优势互补的作用。

Objective To investigate the diagnosis and treatment of bone tumor imaging and pathological correlation.Methods Radiological and pathological data of 50 patients with bone cancer received retrospective analysis. 50 patients underwent digital X-ray photography（ DR） examination,42 cases received computer tomography（ CT） examination,40 patients received magnetic resonance imaging（ MRI） examination,imaging features of bone tumor were compared,and radiological and pathological diagnosis of benign and malignant bone tumors and diagnosis rates were compared. Results DR and CT had similar display in osteoarthritis,destruction,lesion boundary,such as hardening and results,but the DR skull,spine,pelvis lesions,minor lesions,soft tissue shadow as good as CT,DR periosteal reaction in a good performance,MRI in the impact of bone marrow edema and soft tissues specificity were the strongest,but periosteal proliferation,sclerosis,destruction,calcification and other aspects of the situation were worse. DR diagnostic accuracy was 88. 0%,CT diagnostic accuracy was 90. 5%; MRI diagnostic accuracy was95. 0%,there had no statistical difference among the 3 imaging methods for the diagnosis of benign and malignant bone tumors（ P〈0. 05）. Conclusion The preferred method of detection of bone tumors is DR flat piece,CT primary display range and fine structure of tumor,MRI of soft tissue and bone marrow edema have certain advantages,the 3 method combined are complimentary to each other in the diagnosis and treatment of bone tumors.