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本文比较了X线平片、CT及MRI对四肢原发性骨肿瘤的诊断效能。回顾性收集了2012年1月到2018年12月期间入我院治疗的92例四肢原发性骨肿瘤患者的临床资料,比较了各病理类型四肢骨肿瘤发病部位、影像学检查特征和3种影像学检查方法判断良恶性肿瘤的效能。结果显示,92例患者中原发性骨肿瘤发生在肱骨为9.78%(9/92),尺、桡骨为7.61%(7/92),手骨为5.43%(5/92),肩胛、锁骨为2.17%(2/92),股骨为38.04%(35/92),胫、腓骨为17.39%(16/92),足骨为5.43%(5/92),髋骨为14.13%(13/92);X线对骨质增生/硬化和骨膜反应成像较佳,分别占85.87%和57.61%;CT对骨质增生/硬化、软组织肿块和骨膜反应成像较佳,分别占92.39%、66.30%、85.87%;MRI对软组织肿块、骨质增生/硬化、骨膜反应、骨髓水肿成像均较佳,分别占94.57%、82.61%、64.13%、22.83%。92例四肢骨肿瘤中,X线诊断恶性肿瘤的灵敏度为94.57%,均低于CT、MRI诊断的灵敏度(依次为95.65%、97.83%),特异度82.14%,低于CT和MRI的89.29%,而MRI的阳性预测值、阴性预测值和准确率最高,分别为97.83%、89.29%、95.83%。X线、CT的ROC曲线下面积分别为0.767、0.855,均低于MRI的ROC曲线下面积0.942。本文发现X线片、CT、MRI对四肢原发性骨肿瘤的诊断各有优势,尽管MRI检查敏感性、特异性、准确性较高,但是将三者有效结合起来,可以更好地定位定性诊断,避免出现漏诊误诊。
Abstract：To compare the diagnostic efficacy of X-ray, CT and MRI in diagnosing primary bone tumors of extremities, 92 patients with primary bone tumors of the extremities who were admitted to our hospital were retrospectively collected. The results showed that in the 92 patients, primary bone tumors on humeral was 9.78%(9/92), on the ulna and radius were 7.61%(7/92), on the hand bone was 5.43%(5/92), on the scapula and clavicle were 2.17%(2/92), on the femur was 38.04%(35/92), on the tibia and fibula were 17.39%(16/92), on the foot bone was 5.43%(5/92), and on the hip bone was 14.13%(13/92). X-ray imaging with bone hyperplasia, sclerosis and periosteal reaction was better, counting for 85.87% and 57.61% respectively; CT imaging with bone hyperplasia, sclerosis, soft tissue mass and periosteal reaction was better, counting for 92.39%、66.30%、85.87%, respectively. MRI was better for soft tissue mass, bone hyperplasia, sclerosis, periosteal reaction, and bone marrow edema, counting for 94.57%, 82.61%, 64.13% and 22.83% respectively. Among the 92 cases of primary bone tumors of extremities, the X-ray diagnosis with malignant tumors sensitivity was 94.57%, which was lower than the CT(95.65%) and MRI(97.83%). The X-ray specificity was 82.14%, which was lower than the 89.29% of CT and MRI. The area under the ROC curve of X-ray and CT were 0.767 and 0.855, respectively, which were lower than the area under the ROC curve of MRI(0.942). This paper showed that X-ray films, CT and MRI have advantages in the diagnosis for primary bone tumors of the extremities. Although the sensitivity, specificity and accuracy of MRI are high, the three methods can be effectively combined to locate the qualitative diagnosis better, and avoid misdiagnosis and missed diagnosis.
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基本信息:
中图分类号:R730.44;R738.1;R445.2
引用信息:
[1]石岩.X线平片、CT及MRI对四肢原发性骨肿瘤诊断效能比较[J].影像科学与光化学,2019,37(06):571-577.
2019-11-15
2019-11-15