MRI对骨肉瘤骨膜反应的评估价值

Evaluation value of magnetic resonance imaging(MRI)on the periosteal response in Osteosarcoma

目的探讨MRI在检测骨肉瘤骨膜反应中的价值。方法对50例确诊为长骨骨肉瘤患者的X线摄影(DR)和MRI图像进行盲法分析,分析的内容包括:两种影像学检查方法能否检测出骨膜反应以及在DR和MRI图像中分别评估每种骨膜反应的亚型,主要包括层状骨膜反应、针状骨膜反应和Codman三角。结果在检出骨肉瘤骨膜反应方面,MRI成像的敏感度为97.2%,对层状骨膜反应、针状骨膜反应、Codman三角的敏感度分别为75.0%、63.6%、55.6%,阴性预测值分别为94.9%、89.2%、89.7%。MRI与DR在对骨肉瘤侵袭性骨膜反应的分类上差异无统计学意义(P>0.05)。结论MRI对骨肉瘤骨膜反应的检出具有较高的敏感度,但在侵袭性骨膜反应的分类上与DR相比没有明显的差异。

Objective To evaluate the value of magnetic resonance imaging(MRI)in detecting the periosteal response of Osteosarcoma.Methods DR and MRI images of 50 patients diagnosed with long bone Osteosarcoma were analyzed by blind method,the contents of analysis included whether the two imaging methods can detect periosteal reactions and evaluate each subtype of periosteal reactions separately on DR and MRI images.It mainly included laminated subtype,spiculated subtype and Codman’s triangle subtype.Results In the detection of Osteosarcoma periosteal reaction,the sensitivity of MRI imaging was 97.2%,the sensitivity of laminated subtype,spiculated subtype and Codman’s triangle subtype were 75.0%,63.6%,55.6%,and the negative predictive value was 94.9%,89.2%,89.7%,respectively.There was no significant difference between MRI and DR in the classification of invasive periosteum reaction of Osteosarcoma(P>0.05).Conclusion MRI is highly sensitive to the detection of Osteosarcoma periosteal reactions,but there is no significant difference in the classification of invasive periosteal reactions compared with DR.