CT联合CE-MRI、DWI在骨肿瘤、肿瘤样病变鉴别诊断中的应用研究

Application of CT combined with CE-MRI and DWI in differential diagnosis of bone tumors and tumor like lesions

目的探讨CT联合CE-MRI、DWI检查在骨肿瘤、肿瘤样病变鉴别诊断中的应用。方法选取我院经病理证实的骨肿瘤及肿瘤样病变患者36例,对患者行CT检查与CE-MRI检查。使用穿刺活检病理结果作为金标准,比较两组肿瘤恶性、良性检出情况,两种检查诊断灵敏度、特异度及准确度比较以及比较良、恶性肿瘤组的CE-MRI定量参数、ADC值。结果经穿刺活检病理诊断结果显示恶性肿瘤组23例,良性肿瘤组13例。CT检出阳性、阴性例数分别为20例、16例;CE-MRI检出阳性、阴性分别为22例、14例。CT检查与CE-MRI检查灵敏度、特异度比较差异无统计学意义(χ^(2)=0.892,χ^(2)=0.575,P>0.05);CE-MRI诊断准确度高于CT准确度(χ^(2)=5.258,P<0.05)。恶性肿瘤其Ktrans、Kep及iAUC明显高于良性肿瘤组差异有统计学意义(t=2.071,t=2.079,t=5.630,P<0.05);恶性肿瘤组于不同b值下其ADC数值均低于良性肿瘤组(t=2.619,t=2.086,t=2.481,P<0.05)。结论CT联合CE-MRI、DWI检查在骨肿瘤、肿瘤样病变鉴别中有助于诊断骨肿瘤良、恶性,可以为临床诊疗提供有效的参考依据。

Objective To explore the application of CT combined with CE-MRI in the differential diagnosis of bone tumors and tumor like lesions. Methods We selected 36 patients with bone tumors and tumor-like lesions in the imaging department of our hospital. CT examination and CE-MRI examination were performed on the patien. The pathological results of needle biopsy were used as the criterion to compare the detection of malignant and benign tumors between the two groups, the sensitivity, specificity and accuracy of the two examinations, and the CE-MRI quantitative parameters and ADC values of the benign and malignant lesion groups. Results Among the 36 patients, the pathological diagnosis of needle biopsy showed that there were 23 malignant lesions, and the remaining 13 cases were benign lesions. The number of positive and negative cases detected by CT examination were 20 and 16 respectively;the positive and negative cases detected by CE-MRI were 22 and 14 cases respectively. There was no significant difference in the sensitivity and specificity of CT examination and CE-MRI examination(χ^(2)=0.892, χ^(2)=0.575, P0.05);the diagnostic accuracy of CE-MRI was higher than that of CT examination(χ^(2)=5.258, P0.05). K~(trans), K_(ep), and iAUC of malignant tumors were significantly higher than those of benign tumors(t=2.071, t=2.079, t=5.630, P0.05);ADC values of malignant tumors at different b values were lower than those of benign tumors(t=2.619, t=2.086, t=2.481, P0.05). Conclusion CT combined with CE-MRI is helpful to diagnose benign and malignant bone tumors in the differentiation of bone tumors and tumor like lesions, and can provide effective reference for doctors in clinical diagnosis.