动态对比增强磁共振和CT检查对良恶性骨肿瘤的鉴别诊断的研究  

Research of dynamic contrast enhanced magnetic resonance imaging and CT in differential diagnosis of benign and malignant bone tumors

作　　者：陈小龙[1] 安改丽[2] 寇明清[1] 黄明刚[1] 康晓丽[1] 张璐真 邓秦喆 肖庆[1] CHEN Xiaolong;AN Gaili;KOU Mingqing;HUANG Minggang;KANG Xiaoli;ZHANG Luzhen;DENG Qinzhe;XIAO Qing(Medical Imaging Center,Shaanxi People's Hospital,Xi'an 710068,P.R.China;Department of Oncology,Shaanxi People's Hospital,Xi'an 710068,P.R.China)

机构地区：[1]陕西省人民医院医学影像中心,陕西西安710068 [2]陕西省人民医院肿瘤科,陕西西安710068

出　　处：《医学影像学杂志》2020年第10期1902-1907,共6页Journal of Medical Imaging

基　　金：陕西省社会发展科技攻关项目(编号:2016SF117)。

摘　　要：目的探讨动态对比增强磁共振(DCE-MRI)、CT检查对良恶性骨肿瘤的鉴别诊断价值。方法选取我院106例骨肿瘤患者作为观察对象,分别给予CT检查、DCE-MRI检查,统计两种检查方法良恶骨肿瘤诊断情况,以手术病理结果作为金标准,对比两种检查方法诊断效能。结果CT诊断良性骨肿瘤47例,恶性骨肿瘤59例,CT检查符合率为83.96%,灵敏度83.87%,特异性84.09%。DCE-MRI诊断恶性骨肿瘤60例,良性骨肿瘤46例。恶性骨肿瘤时间-信号强度曲线(TIC)曲线最大上升斜率高于良性骨肿瘤,峰值时间低于良性骨肿瘤,差异有统计学意义(P<0.05),DCE-MRI检查符合率为94.34%,灵敏度93.55%,特异性95.45%。CT、DCE-MRI两种检查方法在灵敏度、特异度、误诊率、漏诊率方面对比,差异无统计学意义(P>0.05)。DCE-MRI诊断符合率高于CT检查,差异有统计学意义(P<0.05)。结论与CT检测相比,MRI检查恶性骨肿瘤诊断效果较好,能够提高诊断符合率,两者各有优势与不足,应结合患者临床表现以及病理诊断结果进行综合分析,以降低漏诊、误诊率。Objective To explore the value of dynamic contrast enhanced magnetic resonance(DCE-MRI)and CT in differential diagnosis of benign and malignant bone tumors.Methods One hundred and six cases of bone tumor patients in our hospital were selected as the research objects,and they were given CT examination and DCE-MRI examination respectively.The diagnosis situation of benign and malignant bone tumors was statistically evaluated by two detection methods,the results of operation and pathology were used as the gold standard,and the diagnostic efficiency of the two detection methods was compared.Results CT diagnosis showed that forty-seven cases of benign lesions,fifty-nine cases of malignant lesions.CT detection coincidence rate was 83.96%,sensitivity was 83.87%,specificity was 84.09%.DCE-MRI diagnosis showed that sixty cases of malignant lesions,forty-six cases of benign lesions.The maximum rising slope of the time signal intensity curve(TIC)of malignant tumor was higher than that of benign tumors,the peak time was lower than that of benign tumors,the difference was statistically significant(P<0.05),the coincidence rate of DCE-MRI was 94.34%,sensitivity was 93.55%,specificity was 95.45%.There was no significant difference in sensitivity,specificity,misdiagnosis rate and missed diagnosis rate between the two methods of CT and DCE-MRI(P>0.05).The diagnostic coincidence rate of DCE-MRI was higher than that of CT,the difference was statistically significant(P<0.05).Conclusion Compared with CT detection,MRI has a better effect in the diagnosis of malignant diseases,and can improve the diagnostic coincidence rate,both of them have advantages and disadvantages,and it should be taken comprehensive analysis combined with the clinical manifestations and pathological diagnosis results,so as to reduce missed diagnosis and misdiagnosis rate.

关 键 词：骨肿瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学] R738.1[医药卫生—诊断学]