增强CT定量分析在骨巨细胞瘤定性诊断中的价值

目的探讨MSCT增强扫描CT定量分析在骨巨细胞瘤的定性诊断中的应用价值。方法分别单独应用MSCT增强后强化CT值及强化CT值＋年龄、部位和形态学特征等综合因素对我院329例溶骨性骨肿瘤或肿瘤样病变进行骨巨细胞瘤的前瞻性预判，分别划分骨巨细胞瘤组（实验组）与非骨巨细胞瘤组（对照组）进行统计学分析，定量研究CT增强扫描后CT值的变化特征，并追踪病理结果对照，最终有病理结果的186例中骨巨细胞瘤55例。结果在186例肿瘤或肿瘤样病变中，骨巨细胞瘤55例，增强后强化最显著区域平均CT值为（108±39）HU；非骨巨细胞瘤131例，增强后强化最显著区域平均CT值为（82±78）HU；二者差异有统计学意义（P＜0.05）。当选取CT值临界点为97HU为标准进行预判时，诊断骨巨细胞瘤的敏感性为87.27%，特异性为78.62%，诊断正确率为81.18%；同时结合患者年龄及发病部位、形态特征等综合因素进行预判时，诊断骨巨细胞瘤诊断的敏感性为96.36%，特异性为96.18%，诊断准确率为96.23%。结论 CT增强扫描中CT值的定量分析在骨巨细胞瘤的定性诊断中有较好的导向价值，如果结合患者年龄及发病部位、形态学特征等综合因素进行预判，可以提高术前诊断正确率。

Significance of quantitative analysis of enhanced CT scan in the qualitative diagnosis of the giant cell tumor ofthe bone

Objective To investigate the signiifcance of quantitative analysis of enhanced MSCT scan in the qualitative diagnosis of the giant cell tumor of the bone. Methods The prospective anticipation of the giant cell tumor of the bone by enhanced MSCT scan was conducted. CT value, age, location and morphological characteristics were included. 329 cases of a random period with soluble osseous bone tumors or tumor-like disorders of the bone were analyzed. All patients were divided into 2 groups. Group A：cases with the giant cell tumor of the bone （ experimental group, n=55 ）. Group B： cases without giant cell tumor of the bone （ control group, n=131 ）. All patients were examined with enhanced CT scan and the CT values were analyzed quantitatively. 186 patients with pathological results were compared, including 55 patients with giant cell tumor of the bone. Results In the giant cell tumor of the bone group, the average CT value of the most signiifcant enhanced region was （ 108±39 ） HU, as well as the average enhanced CT value was （ 82±78 ） HU in the non-giant cell tumor group. There was signiifcant difference between the 2 groups （ P〈0.05 ）. If we only make a preliminary diagnosis according to the standard of enhanced CT value≥97 HU, the sensitivity rate, speciifcity rate and accuracy rate on the diagnosis of the giant cell tumor were 87.27%, 78.62%and 81.18%respectively. However, if we make a preliminary diagnosis according to the standard of enhanced CT value≥97 HU combined with patient’s age, location, morphological characteristics, and other comprehensive factors, the sensitivity rate, speciifcity rate and accuracy rate on the diagnosis of the giant cell tumor of bone were 96.36%, 96.18%and 96.23%respectively. Conclusions Enhanced CT scan is of signiifcance in the diagnosis of the giant cell tumor of the bone. The diagnostic accuracy can be improved if we make diagnosis not only according to the enhanced CT value but also combine it with patient’s age, location, morphological characters, and other comprehensive factors.