磁共振联合常规CT在骨细胞瘤筛检及诊断中的价值探讨  

The Value Discussion of MRI Combined with Conventional CT in Screening and Diagnosis of Osteoblastoma

作　　者：杨俊飞 YANGJunfei(Department of minimally invasive intervention,Inner Mongolia hospital,Peking university cancer hospital,Hohhot,Inner Mongolia 010020)

机构地区：[1]北京大学肿瘤医院内蒙古医院微创介入科,内蒙古呼和浩特010020

出　　处：《中国伤残医学》2024年第9期9-12,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨磁共振(MR)联合常规CT在骨细胞瘤筛检及诊断中的应用价值。方法:选取2020年4月-2023年4月我院80例高度疑似骨细胞瘤患者作为研究对象,所有患者均行MR及常规CT检查,分析MR及常规CT的检查结果及影像学表现,以病理学检查结果为金标准,比较MR及常规CT单独及联合检查的结果与金标准的一致性,对比其诊断效能。结果:80例高度疑似骨细胞瘤患者最终确诊阳性66例,阴性14例。病变部位主要集中在股骨远端、胫骨近端、桡骨远端、肽骨近端等位置。MR以边界清晰,T1WI序列不均匀低、等信号,T2WI序列不均匀低、等、高混杂信号为主要征象;常规CT以囊性膨胀破坏区、骨皮质变薄或中断、瘤体内见骨、软组织密度影为主要征象。MR联合常规CT检查与金标准结果具有较好一致性(Kappa=0.726),强于MR或常规CT单独检查(MR Kappa=0.535;常规CT Kappa=0.561)。MR联合常规CT检查对骨细胞瘤诊断的灵敏度、准确度及阴性预测值高于单独MR或者常规CT检查,差异有统计学意义(P<0.05),特异度、阳性预测值高于单独MR或者常规CT检查,差异无统计学意义(P>0.05)。结论:长骨为骨细胞瘤多发部位,MR及常规CT能够较好地呈现骨细胞瘤病变信息,MR在识别骨细胞瘤与周边软组织、神经、血管关系上更具优势,常规CT可以检查出骨质破坏、内部组织侵犯等情况,两者联合使用能够提高诊断灵敏度及准确度,并且可以为医生后续诊治提供综合性参考。Objective:To investigate the value of magnetic resonance(MR)combined with conventional CT in the screening and diagnosis of osteoblastoma.Methods:80 patients with highly suspected osteoblastoma in our hospital from April 2020 to April 2023 were selected as research objects.All patients underwent MR and conventional CT examination.The examination results and imaging findings of MR And conventional CT were analyzed,and pathological examination results were taken as the gold standard.The diagnostic efficiency was compared.Results:66 were positive and 14 were negative in 80 patients with highly suspected osteoblastoma.The lesions were mainly concentrated in the distal femur,proximal tibia,distal flexion and proximal humerus.The main signs of MR were clear boundary,uneven low,equal signal of T1WI sequence,uneven low,equal,high mixed signal of T2WI sequence.The main signs of conventional CT were cystic dilatation and destruction area,thinning or interruption of bone cortex,bone ridge and soft tissue density shadow in tumor.The results of MR combined with conventional CT were better consistent with gold standard(Kappa=0.726)than those of MR or conventional CT alone(MR Kappa=0.535;conventional CT Kappa=0.561).The sensitivity,accuracy and negative predictive value of MR combined with conventional CT for the diagnosis of osteoblastoma were higher than those of MR alone or conventional CT,the differences were statistically significant(P<0.05),while the specificity and positive predictive value were higher than those of MR alone or conventional CT,the differences were not statistically significant(P>0.05).Conclusion:Long bone is the most frequent site of osteoblastoma,MR and conventional CT can better present the pathological information of osteoblastoma,MR is more advantageous in identifying the relationship between osteoblastoma and surrounding soft tissues,nerves and blood vessels,CT can detect bone destruction and internal tissue invasion,and the combination of the two metheds can improve the sensitivity and accuracy of

关 键 词：骨细胞瘤 磁共振 常规CT 诊断效能 影像学表现 

分 类 号：R738.1[医药卫生—肿瘤]