能谱CT在肌骨肿块良恶性鉴别诊断中的应用

Application of Energy Spectrum CT in Differential Diagnosis of Benign and Malignant Musculoskeletal Masses

目的 探究能谱CT在肌骨肿块良恶性鉴别诊断中的应用价值。方法 选择2021年6月-2022年6月在本院就诊的经MRI检查显示有软组织肿块且择期进行手术治疗的82例肌骨肿瘤患者,均进行能谱CT检查,并对感兴趣区域绘制keV-CT值曲线。根据82例患者手术病理结果分为良性组(n=31)、恶性组(n=43)、交界组(n=8),比较三组keV-CT曲线形态及其平均斜率值。结果 恶性组keV-CT曲线呈急降型,良性组keV-CT曲线为缓慢下降型,且恶性组keV-CT曲线平均斜率显著高于良性组和交界组(P<0.05),良性组平均斜率值也明显低于交界组(P<0.05)。ROC曲线分析显示,当keV-CT曲线平均斜率临界值1.155时,鉴别诊断恶性肌骨肿瘤的灵敏度81.40%,特异性91.05%。结论 能谱CT曲线对鉴别诊断肌骨肿块良恶性有较高的价值。

Objective To explore the value of energy spectrum CT in the differential diagnosis of benign and malignant musculoskeletal masses.Methods From June 2021 to June 2022,82 cases of patients with musculoskeletal tumors who showed soft tissue masses by MRI examination and underwent elective surgery were selected.All patients were examined by energy spectrum CT,and the keV-CT value curve was drawn for the region of interest.82 cases of patients were divided into benign group(n=31),malignant group(n=43)and borderline group(n=8)according to the surgical and pathological results.The shape of keV-CT curve and its average slope were compared among the three groups.Results The keV-CT curve of malignant group showed a rapid decline,while that of benign group showed a slow decline.The average slope of keV-CT curve in malignant group was significantly higher than that of the benign group and borderline group(P<0.05),and the slope in benign group was also significantly lower than that of the borderline group(P<0.05).ROC curve analysis showed that when the average slope of keV-CT curve was 1.155,the sensitivity and specificity of differential diagnosis of malignant musculoskeletal tumors were 81.40%and 91.05%.Conclusion The energy spectrum CT curve has a high value in the differential diagnosis of benign and malignant musculoskeletal masses.