骨肿瘤影像学与病理学的相关性研究
|
摘要
目的探讨骨肿瘤诊疗过程中病理学与影像学的相关性。方法回顾性分析骨肿瘤120例患者的病理学与影像学资料,所有患者均进行了X线检查,其中49例行MRI检查,46例行CT检查。分别比较肿瘤的影像学特征与病理诊断结果的关系,判断良恶性肿瘤的影像学诊断正确率。结果 X线检查与CT检查在对相关骨肿瘤周围骨质增生、硬化、破坏、病灶边界等方面表现相似,但在脊柱、骨盆病灶、头颅、软组织阴影、细微病灶等特殊部位其显像CT更为清晰,而X线在骨膜方面表现良好,对于软组织、骨髓水肿的显像方面MRI表现更为优秀。与术后病理学诊断结果为标准:X线诊断正确率为86.67%,CT诊断正确率为93.47%;MRI诊断正确率为93.88%,3种影像学检查对骨肿瘤良恶性的诊断正确率方面比较差异无统计学意义(P>0.05)。结论 X线由于方便、快捷的优势可作为骨肿瘤诊断的首选诊断,CT对于细微病灶、肿瘤的范围具有一定优势,MRI对于软组织、骨髓水肿显像优势明显,3种检查方法可作为骨肿瘤诊断的互补检查,提高诊断的准确性。
Objective To investigate the correlation between bone tumor pathology and imaging. Methods Pathology and imaging data of 120 cases of patients with bone tumors were retrospectively studied,all patients underwent X-ray examination,in which 49 patients underwent MRI examination,46 patients underwent CT examination. Tumor characteristics were compared with pathologic and imaging,benign and malignant tumors judgment imaging diagnostic accuracy. Results X-ray and CT examination of the relevant aspects of the surrounding bone tumors hyperostosis,sclerosis,damage,and other symptoms similar lesion boundary,but in special parts of the spine,pelvis lesions,skull,soft tissue shadow,subtle lesions and other developing its CT clearer,and X-ray performed well in the periosteum,soft tissues,bone marrow edema imaging MRI in terms of the more outstanding.Pathology and diagnostic gold standard diagnostic accuracy,X-ray diagnostic accuracy was 86. 67%,CT diagnostic accuracy rate was 93. 47%; MRI diagnostic accuracy rate was 93. 88%,all 3 imaging for the diagnosis of benign and malignant bone tumors had no significant difference( P > 0. 05). Conclusion X line due to the convenient,quick advantage is the preferred diagnostic bone tumor diagnosis,CT for minor lesions,extent of the tumor has certain advantages,MRI for soft tissue,bone marrow edema imaging obvious advantages,3 methods can be used as bone tumors complementary diagnostic check,improve diagnostic accuracy.
Objective To investigate the correlation between bone tumor pathology and imaging. Methods Pathology and imaging data of 120 cases of patients with bone tumors were retrospectively studied,all patients underwent X-ray examination,in which 49 patients underwent MRI examination,46 patients underwent CT examination. Tumor characteristics were compared with pathologic and imaging,benign and malignant tumors judgment imaging diagnostic accuracy. Results X-ray and CT examination of the relevant aspects of the surrounding bone tumors hyperostosis,sclerosis,damage,and other symptoms similar lesion boundary,but in special parts of the spine,pelvis lesions,skull,soft tissue shadow,subtle lesions and other developing its CT clearer,and X-ray performed well in the periosteum,soft tissues,bone marrow edema imaging MRI in terms of the more outstanding.Pathology and diagnostic gold standard diagnostic accuracy,X-ray diagnostic accuracy was 86. 67%,CT diagnostic accuracy rate was 93. 47%; MRI diagnostic accuracy rate was 93. 88%,all 3 imaging for the diagnosis of benign and malignant bone tumors had no significant difference( P > 0. 05). Conclusion X line due to the convenient,quick advantage is the preferred diagnostic bone tumor diagnosis,CT for minor lesions,extent of the tumor has certain advantages,MRI for soft tissue,bone marrow edema imaging obvious advantages,3 methods can be used as bone tumors complementary diagnostic check,improve diagnostic accuracy.
引文
[1]Elefteriou F,Yang X.Genetic mouse models for bone studies-Strengths and limitations〔J〕.Bone,2011,49(6):1242-1254.
[2]王玉凯.骨肿瘤X线诊断学〔M〕.北京:人民卫生出版社,1995:44-71.
[3]王子轩,刘吉华,曹庆选,等.骨关节解剖与疾病影像诊断.第1版〔M〕.北京:人民卫生出版社,2009:18.
[4]段承祥,王晨光,李健丁.骨肿瘤影像学〔M〕.第1版.北京:科学出版社,2004:1-5.
[5]上官景俊,徐文坚,李文,等.骨肿瘤与瘤样病变周围组织影像表现分析〔J〕.中华放射学杂志,2011,45(5):463-467.
[6]李伟,张成琪,王新恰,等.能谱CT和MRI在手肌腱病变中的应用〔J〕.医学影像学杂志,2011,21(11):1759-1762.
[7]王君君,张成琪,邓凯.宝石能谱CT显示肌腱的最佳单能量〔J〕.医学影像学杂志,2011,21(8):1252-1254.
[8]Crnalic S,Hakansson I,Boquist L,et al.A novel spontaneous metastasis model of human osteosarcoma developed using orthotopic transplantation of intact tumor tissue into tibia of nude mice〔J〕.Clin Exp Metastasis,1997,15(2):164-172.
[9]王臻.恶性骨肿瘤的临床治疗现状及展望〔J〕.中国修复重建外科杂志,2006,20(10):961-964.
[10]林晓珠,沈云,陈克敏.CT能谱成像的基本原理与临床应用研究进展〔J〕.中华放射学杂志,2011,45(8):798-800.
[11]王明亮,林晓珠,缓飞,等.CT能谱成像对物质内碘含量测定的价值:体模研究〔J〕.中国医学计算机成像杂志,2011,17(2):172-175.
[12]赵永为,郭小超,王霄英,等.扫描视野对双能CT成像CT值及物质分离的影响--模体研究〔J〕.放射学实践,2012,27(3):271-273.
[13]李爱,任翠萍,程敬亮,等.骨肉瘤的X线、CT及MRI比较分析(附61例分析)〔J〕.放射学实践,2011,26(11):1197-1200.
[2]王玉凯.骨肿瘤X线诊断学〔M〕.北京:人民卫生出版社,1995:44-71.
[3]王子轩,刘吉华,曹庆选,等.骨关节解剖与疾病影像诊断.第1版〔M〕.北京:人民卫生出版社,2009:18.
[4]段承祥,王晨光,李健丁.骨肿瘤影像学〔M〕.第1版.北京:科学出版社,2004:1-5.
[5]上官景俊,徐文坚,李文,等.骨肿瘤与瘤样病变周围组织影像表现分析〔J〕.中华放射学杂志,2011,45(5):463-467.
[6]李伟,张成琪,王新恰,等.能谱CT和MRI在手肌腱病变中的应用〔J〕.医学影像学杂志,2011,21(11):1759-1762.
[7]王君君,张成琪,邓凯.宝石能谱CT显示肌腱的最佳单能量〔J〕.医学影像学杂志,2011,21(8):1252-1254.
[8]Crnalic S,Hakansson I,Boquist L,et al.A novel spontaneous metastasis model of human osteosarcoma developed using orthotopic transplantation of intact tumor tissue into tibia of nude mice〔J〕.Clin Exp Metastasis,1997,15(2):164-172.
[9]王臻.恶性骨肿瘤的临床治疗现状及展望〔J〕.中国修复重建外科杂志,2006,20(10):961-964.
[10]林晓珠,沈云,陈克敏.CT能谱成像的基本原理与临床应用研究进展〔J〕.中华放射学杂志,2011,45(8):798-800.
[11]王明亮,林晓珠,缓飞,等.CT能谱成像对物质内碘含量测定的价值:体模研究〔J〕.中国医学计算机成像杂志,2011,17(2):172-175.
[12]赵永为,郭小超,王霄英,等.扫描视野对双能CT成像CT值及物质分离的影响--模体研究〔J〕.放射学实践,2012,27(3):271-273.
[13]李爱,任翠萍,程敬亮,等.骨肉瘤的X线、CT及MRI比较分析(附61例分析)〔J〕.放射学实践,2011,26(11):1197-1200.