基于CT、MRI影像特征等对四肢伴明显动脉瘤样骨囊肿的骨巨细胞瘤与原发性动脉瘤样骨囊肿鉴别诊断的价值

Value of CT and MRI imaging features in differential diagnosis of giant cell tumors with prominent aneurysmal bone cysts in the extremities and primary aneurysmal bone cysts

目的探讨CT、MRI影像特征等对四肢伴明显动脉瘤样骨囊肿的骨巨细胞瘤(giant cell tumours with prominent aneurysmal bone cysts,GABCs)和原发性动脉瘤样骨囊肿(primary aneurysmal bone cysts,PABCs)的鉴别诊断价值。方法回顾性分析20例四肢GABCs和21例PABCs患者的CT和MRI影像特征,并同时收集患者的年龄和性别,比较两组不同指标间差异,并计算两组患者的年龄、包块横径/纵径比、软骨下骨受累、病变边缘深分叶、包块周围血管影对GABCs及PABCs诊断的灵敏度、特异度。结果两组患者的年龄、包块横径/纵径比比较差异有显著性(t=-3.956、-2.985,P<0.05),两组患者的软骨下骨受累的比例、病变边缘深分叶的比例、包块周围血管影的比例比较差异有显著性(P<0.05)。年龄、包块横径/纵径比、软骨下骨受累和病变边缘深分叶对GABCs患者诊断的灵敏度分别为75.0%、65.0%、68.0%和80.0%,特异度分别为81.0%、66.7%、81.3%和61.3%。相反,包块周围血管影诊断PABCs的灵敏度为52.4%,特异度为95.0%。结论CT和MRI影像特征中的软骨下骨受累、病变边缘深分叶、包块横径/纵径比高低以及包块周围血管影及患者年龄高低对GABCs和PABCs具有鉴别诊断的价值。

Objective To explore the value of computerized tomography(CT)and magnetic resonance imaging(MRI)imaging features in differential diagnosis of giant cell tumors with prominent aneurysmal bone cysts(GABCs)in the extremities and primary aneurysmal bone cysts(PABCs).Methods In this study,the CT and MRI imaging features of 20 patients with GABCs in the extremities and 21 patients with PABCs were retrospectively analyzed,and the age and sex of patients were collected.The differences in different indicators between the two groups were compared.The diagnostic sensitivity and specificity for GABCs and PABCs were calculated based on the age,transverse/longitudinal diameter ratio of the mass,subchondral bone involvement,deep edge lobulation of the lesion,and vascular shadow around the mass.Results There were significant differences in the age and transverse/longitudinal diameter ratio of the mass between the two groups(t=-3.956,-2.985,P<0.05).There were signi-ficant differences in the proportions of subchondral bone involved,deep edge lobulation of the lesion,and vascular shadow around the mass between the two groups(P<0.05).The sensitivity of age,transverse/longitudinal diameter ratio of the mass,subchondral bone involvement,and deep edge lobulation of the lesion in the diagnosis of GABCs was 75.0%,65.0%,68.0%,and 80.0%,respectively,and the specificity was 81.0%,66.7%,81.3%,and 61.3%,respectively.The sensitivity of vascular shadow around the mass in the diagnosis of PABCs was 52.4%,and the specificity was 95.0%.Conclusion Patient age and CT and MRI imaging features such as subchondral bone involvement,deep edge lobulation of the lesion,transverse/longitudinal diameter ratio of the mass,and vascular shadow around the mass can be used to distinguish GABCs from PABCs.