增强扫描CT值在骨巨细胞瘤诊断中的价值  

Evaluation of contrast-enhanced CT value in the diagnosis of giant cell tumor

作　　者：孙伟杰 苏永彬 王玲 过哲 王继琛[2] 王予生 赵海竹 顾翔 程晓光 

机构地区：[1]积水潭医院放射科,北京100035 [2]南京医科大学附属医院南京明基医院放射科

出　　处：《中华放射学杂志》2013年第5期444-448,共5页Chinese Journal of Radiology

基　　金：北京市卫生系统高层次卫生技术人才培养项目资助（2009-02-03）

摘　　要：目的探讨增强扫描CT值在骨巨细胞瘤诊断中的价值。方法从2461例行CT增强扫描的骨肿瘤和瘤样病变中筛选出408例表现为溶骨性骨质破坏病变的患者。每例患者选择3个ROI，把增强后CT值均值和CT值增加值均值作为观测值。使用软件从408例中随机抽选30例，由2名医师分别测量，使用配对样本t检验对2名医师的测量结果进行比较，计算CT值测量方法的总体精密度。将142例骨巨细胞瘤按照对比剂分为碘海醇组（350mgI／ml）、碘普胺组（370mgI／ml）和碘比醇组（350mgI／ml），使用单因素方差分析对2个观测值进行分析，同样将408例分为3组并进行分析。将408例患者按照病理诊断分为骨巨细胞瘤组和非骨巨细胞瘤组，利用ROC曲线分析获得骨巨细胞瘤的增强后CT值均值和增加值均值的诊断临界值以及诊断临界值各自的敏感度、特异度。结果2名医师间测量增强后CT值均值差异无统计学意义（t=0．178，P〉0．05），CT值增加值均值差异也无统计学意义（t=0．682，P〉0．05），CT值测量的总体精密度为11．94％。3组对比剂间：142例骨巨细胞瘤增强后CT值均值3组分别为（126．41±27．13）、（128．90±23．12）、（127．61±23．02）HU，组问差异无统计学意义（F=0．10，P〉0．05），CT值增加值均值3组分别为（82．72±24．83）、（81．94±21．71）、（84．06±19．45）HU，组间差异也无统计学意义（F=0．05，P〉0．05）；408例病变增强后CT值均值3组分别为（99．15±36．44）、（107．08±39．28）、（105．75±31．17）HU，组间差异无统计学意义（F=1．905，P〉0．05），CT值增加值均值3组分别为（58．63±33．23）、（64．40±36．38）、（63．04±28．50）HU，组间差异也无统计学意义（F=1．149，P〉0．05）。骨巨细胞瘤和非骨巨细胞瘤的增强后CT值均值分别为（127．05±25．69）和（88．07±34．08）HU；骨巨�Objective To evaluate the contrast-enhanced CT value in the diagnosis of giant cell tumor. Methods From 2461 hone tumors and tumor-like lesions with contrast enhanced CT ,408 osteolytic lesions were selected and analyzed retrospectively. Three ROI were selected for every lesion, then the average post-contrast CT value and average △CT value of every lesion were calculated by two observersindependently. Thirty lesions which were randomly selected from the 408 lesions were measured by two doctors to assess the overall precision of measurements. Contrast agents Iohexol （350 mg I/ml） , Iopromide （370 nlg I/ml） and Iobitridol（350 mg I/ml） were recorded in 148 GCT and 408 osteolytic lesions. The two observed values were analyzed respectively by using the One-way ANOVA. The 408 lesions were divided into giant cell tumor （GCT） and non-giant cell tumor （non-GCT） according to pathological results, and ROC curve analysis was carried out to get the cutoff values for the diagnosis of GCT and their sensitivity, specificity were determined. Results There was no significant difference of the average post contrast CT values between two observers （ t = 0. 178, P 〉 0. 05 ）, nor the average △CT values （ t = 0. 682, P 〉 0. 05 ） , and the overall precision was 11.94%. There was no significant difference amongst the three groups average post contrast CT values（ 126.41 ± 27.13）, （ 128.90 ± 23.12）, （ 127.61 ± 23.02） HU for the 142 giant cell tumors （ F = 0. 10, P 〉 0.05 ） , nor the average △CT values （ 82. 72 ± 24.83 ） , （ 81.94 ±21.71 ） , （ 84. 06 ± 19.45 ） HU （ F = 0. 05,P 〉 0. 05 ）. There was no significant difference amongst the three groups average post contrast CT values （99. 15 ± 36.44） , （ 107.08 ± 39.28 ） , （ 105.75 ± 31. 17 ） HU for the 408 lesions （ F = 1. 905, P 〉 0. 05 ）, nor the average △CT values （ 58.63 ± 33.23 ）, （ 64. 40 ± 36.38 ）, （ 63.04 ±28.50 ） HU （F = 1. 149,P 〉 0. 05 ）. The average post contra

关 键 词：成骨细胞瘤 诊断 体层摄影术 X线计算机 

分 类 号：R730.44[医药卫生—肿瘤]