四肢长骨感染性炎症和骨肿瘤的影像学改变及鉴别诊断

Value of imaging changes in differential diagnosis of limbs long bone infections and bone tumors

目的研究四肢长骨感染性炎症和骨肿瘤影像学改变,为临床鉴别诊断提供参考依据。方法选取2013年1月-2016年1月医院诊治的82例四肢长骨感染患者为试验组,选取同期入院的74例骨肿瘤患者为对照组,两组患者入院后均给予X线、CT以及MRI检查,对两组患者检查征象进行界定、观察记录,比较四肢长骨感染性炎症和骨肿瘤影像学改变及鉴别诊断效果。结果试验组患者病灶部位排在前3位的分别为胫骨、股骨、肱骨,分别占34.15%、23.17%及17.07%;对照组患者病灶部分排在前3位的分别为胫骨、股骨、肱骨,分别占32.43%、28.38%及16.22%,两组比较差异无统计学意义;试验组患者骨骼改变征象排在前3位的分别为死骨、髓腔脓肿以及层状连续骨膜新生骨,分别占100.00%、100.00%及93.88%;对照组骨骼改变征象排在前3位的分别为Codman三角、骨干髓腔变化以及病变边界清晰,分别占95.74%、94.00%及87.10%,两组比较差异有统计学意义(P<0.05)。结论四肢长骨感染性炎症和骨肿瘤患者通过X线、CT以及MRI检查等方法进行鉴别、诊断,能提高确诊率,值得在临床中推广应用。

OBJECTIVE To explore the imaging changes of limbs long bone infections and bone tumors so as to provide guidance for clinical differential diagnosis.METHODS Totally 82 patients with limbs long bone infections who were treated in hospitals from Jan 2013 to Jan 2016 were chosen as the experimental group,meanwhile,74 patients with bone tumors were set as the control group.The two groups of patients were treated with X-ray,CT,and MRI examinations,the examination signs were defined,observed,and recorded.The imaging changes and the effects on differential diagnosis were observed and compared between the patients with limbs long bone infections and the patients with bone tumors.RESULTS The tibia,femur,and humerus ranked the top 3lesion sites among the patients in the experimental group,accounting for 34.15%,23.17%,and 17.07%,respectively;tibia,femur,and humerus ranked the top 3lesion sites among the patients in the control group,accounting for 32.43%,28.38%,and 16.22%,respectively,and there was no significant difference between the two groups.The dead bone,marrow cavity abscess and continuous lamellar periosteal bone ranked the top 3skeletal change signs among the patients in the experimental group,accounting for 100.00%,100.00%,and 93.88%,respectively.The Codman triangle,change of femoral medullary cavity,and lesions with clear boundaries ranked the top 3skeletal change signs among the patients in the control group,accounting for 95.74%,94.00%,and 87.10%,respectively,and there was significant difference between the two groups（P〈0.05）.CONCLUSION The X-ray,CT,and MRI can be used for the differential diagnosis of the limbs long bone infection and bone tumors,which may raise the diagnosis rate and are worthy to be promoted in the hospital.