MRI对原发恶性骨肿瘤跨骶髂关节侵犯的临床诊断价值

目的探讨MRI对原发恶性骨肿瘤跨骶髂关节侵犯的临床诊断价值。方法将2014年7月至2018年7月我院收治的85例原发恶性骨肿瘤患者作为研究对象,其中高度恶性52例、低度恶性33例,髂骨60例、骶骨25例。分析MRI对原发恶性骨肿瘤跨关节侵犯的诊断价值,及不同部位、不同病理跨关节侵犯的发生率情况。结果85例原发恶性骨肿瘤患者手术病理显示跨骶髂关节侵犯21例,MRI检查检出20例,诊断符合率为98.82%(84/85),诊断敏感性为95.24%(20/21),特异性为100.0%(64/64)。高度恶性、低度恶性跨关节侵犯率差异具有统计学意义(P<0.05)。髂骨、骶骨跨关节侵犯的方式差异无统计学意义(P>0.05)。高度恶性、低度恶性跨关节侵犯的方式无明显统计学差异(P>0.05)。结论MRI对原发恶性骨肿瘤跨关节侵犯诊断价值高,恶性程度越高,跨关节侵犯率也越高,而侵犯方式与肿瘤部位、肿瘤病理恶性程度无关,值得临床选择。

Clinical Value of MRI in Diagnosing Sacroiliac Joint Involvement in Primary Malignant Bone Tumors

Objective To evaluate the clinical value of MRI in diagnosing sacroiliac joint involvement in primary malignant bone tumors. Methods From July 2014 to July 2018, 85 patients with primary malignant bone tumors were treated in our hospital were studied. Among them, 52 were highly malignant, 33 cases were low malignant, 60 cases were iliac and 25 cases were sacral. Analyzed the value of MRI in the diagnosis of primary malignant bone tumors with transarticular invasion, and the incidence of transarticular invasion in different sites and pathologies. Results Surgical and pathological findings of 85 patients with primary malignant bone tumors showed 21 cases of transsacroiliac joint involvement and 20 cases of MRI detection. The diagnostic accuracy was 98.82%(84/85), the sensitivity was 95.24%(20/21) and the specificity was 100.0%(64/64). No significant difference was found in the rate of iliac and sacral trans-articular invasion(P>0.05). There was a significant difference in the rate of cross joint aggression(P<0.05). There was no significant difference in the way between the ilium and sacrum across the joint(P>0.05). There was no significant difference in the pattern of high-grade malignant and low-grade malignant transarticular invasion(P>0.05). Conclusion MRI is of high diagnostic value for primary malignant bone tumors with trans-articular invasion, the higher the malignant degree, the higher the trans-articular invasion rate.