CT成像在老年骨肿瘤定性诊断中的价值研究
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摘要
目的探讨CT成像在老年骨肿瘤定性诊断中的价值,为该病的诊断提供参考方法。方法回顾性分析2016年2月～2018年2月在河北省沧州市中心医院就诊的经病理组织学证实的60例老年骨肿瘤患者的病例资料,所有患者在手术前均进行了X线和CT成像检查,根据手术病理检查结果,比较X线和CT成像检查对骨肿瘤诊断的准确性。结果60例入选患者中24例为骨良性肿瘤,36例为骨恶性肿瘤,其中CT诊断良性肿瘤的准确率显著高于X线诊断(87.50%vs 62.50%,P<0.05); CT诊断恶性肿瘤的准确率显著高于X线诊断(88.89%vs 63.89%,P<0.05);CT诊断所有骨肿瘤的准确率显著高于X线诊断(88.33%vs 63.33%,P<0.05)。结论相比于X线检查,CT检查对骨外软组织和病变内部组织显影更加清晰,病变检出率和准确性高,在骨肿瘤定性诊断中具有一定的参考价值。
Objective To explore the value of CT imaging in qualitative diagnosis of bone tumor in the elderly. Methods A retrospective analysis was made to the clinical data of 60 elderly with bone tumor confirmed by histopathological study during the period from Feb., 2016 to Feb., 2018; all the elderly receive X-ray and CT imaging before surgery and a comparative study was made on the accuracy between X-ray and CT imaging in diagnosing bone tumor based on the results of post-operative pathological study. Results Out of the enrolled 60 elderly, benign bone tumors were found in 24 elderly and bone malignant tumors in 36 elderly; the accuracies of CT imaging in diagnosing benign bone tumors, bone malignant tumors and all the bone tumors were significantly higher than those of X-ray imaging [(87.50% vs. 62.50%),(88.89% vs. 63.89%) and(88.33% vs. 63.33%)](P<0.05). Conclusions CT imaging demonstrates the development of extra-osseous soft tissue and internal tissue of lesions more clearly than X-ray imaging with high lesion detection rate and high accuracy; it is of certain reference value in qualitative diagnosis of bone tumor.
Objective To explore the value of CT imaging in qualitative diagnosis of bone tumor in the elderly. Methods A retrospective analysis was made to the clinical data of 60 elderly with bone tumor confirmed by histopathological study during the period from Feb., 2016 to Feb., 2018; all the elderly receive X-ray and CT imaging before surgery and a comparative study was made on the accuracy between X-ray and CT imaging in diagnosing bone tumor based on the results of post-operative pathological study. Results Out of the enrolled 60 elderly, benign bone tumors were found in 24 elderly and bone malignant tumors in 36 elderly; the accuracies of CT imaging in diagnosing benign bone tumors, bone malignant tumors and all the bone tumors were significantly higher than those of X-ray imaging [(87.50% vs. 62.50%),(88.89% vs. 63.89%) and(88.33% vs. 63.33%)](P<0.05). Conclusions CT imaging demonstrates the development of extra-osseous soft tissue and internal tissue of lesions more clearly than X-ray imaging with high lesion detection rate and high accuracy; it is of certain reference value in qualitative diagnosis of bone tumor.
引文
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[20] Chen YR, Kuo YC, Hsu CN, et al. False suggestion of malignant transformation of benign bone tumor by 18F-FDG PET/CT:A potential pitfall[J]. ClinNucl Med, 2016, 41(10):774-775.
[2] Chen A, Wang L, Liu S, et al. Attraction and compaction of migratory breast cancer cells by bone matrix proteins through Tumor-Osteocyte interactions[J]. Sci Rep, 2018, 8(1):5420.
[3] Errani C, Tsukamoto S, Leone G, et al. Denosumab May increase the risk of local recurrence in patients with Giant-Cell tumor of bone treated with curettage[J]. J Bone Joint Surg Am, 2018,100(6):496-504.
[4] Fioramonti M, Fausti V, Pantano F, et al. Cabozantinib affects osteosarcoma growth through a direct effect on tumor cells and modifications in bone microenvironment[J]. Sci Rep, 2018, 8(1):4177.
[5] Broehm CJ, Inwards CY, Al-Ibraheemi A, et al. Giant cell tumor of bone in patients 55 years and older:a study of 34 patients[J].Am J ClinPathol, 2018, 149(3):222-233.
[6] Moffett SP, Zmuda JM, Oakley JI, et al. Tumor necrosis factoralpha polymorphism, bone strength phenotypes, and the risk of fracture in older women[J]. J ClinEndocrinolMetab, 2005, 90(6):3491-3497.
[7]杨迪生,高翔.老年患者若干骨恶性肿瘤的治疗进展[J].老年医学与保健,2007(6):332-335.
[8] Fournel L, Rapicetta C, Fraternali A, et al. Fibrous dysplasia of the rib mimicking a malignant bone tumor at SPECT/CT with99mTc-MDP[J]. ClinNucl Med, 2018, 43(5):346-348.
[9]孙贞魁,孙文萍,郗艳,等.原发性骨淋巴瘤影像特点[J].老年医学与保健,2015,21(1):20-23.
[10] Yi J, Lee YH, Kim SK, et al. Response evaluation of giantcell tumor of bone treated by denosumab:Histogram and texture analysis of CT images[J]. J OrthopSci, 2018, 23(3):570-577.
[11] Bongiovanni A, Recine F, Celli M, et al. Osteoblastic bone metastases from neuroendocrine tumor(NET)of unknown origin detected by 18fluorocholine PET/CT and its comparison with68gallium-DOTATOC PET/CT:Case report and review of the literature[J]. Medicine(Baltimore), 2017, 96(46):e8567.
[12] Holmes MG, Foss E, Joseph G, et al. CT-Guided bone biopsies in metastatic Castration-Resistant prostate cancer:factors predictive of maximum tumor yield[J]. J VascIntervRadiol, 2017,28(8):1073-1081.e1.
[13] Ranade R, Basu S. Metabolic bone disease in the context of metastatic neuroendocrine tumor:differentiation from skeletal metastasis, the molecular PET-CT imaging features, and exploring the possible etiopathologies including parathyroid adenoma(MEN1)and paraneoplastic humoral hypercalcemia of malignancy due to PTHrPhypersecretion[J]. World J Nucl Med, 2017,16(1):62-67.
[14] Park HJ, Kwon SY, Cho SG, et al. Giant cell tumor with secondary aneurysmal bone cyst shows heterogeneous metabolic pattern on 18F-FDG PET/CT:A case report[J]. Nucl Med Mol Imaging(2010), 2016, 50(4):348-352.
[15] Etchebehere EC, Araujo JC, Milton DR, et al. Skeletal tumor burden on baseline 18F-Fluoride PET/CT predicts bone marrow failure after 223Ra therapy[J]. ClinNucl Med, 2016, 41(4):268-273.
[16] Panizza PS, de Albuquerque Cavalcanti CF, Yamaguchi NH, et al. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor[J].CardiovascInterventRadiol, 2016, 39(2):299-303.
[17] Adams HJ, De Klerk JM, Fijnheer R, et al. Does the presence of tumor-induced cortical bone destruction at CT have any prognostic value in newly diagnosed diffuse large B-cell lymphoma?[J]. Skeletal Radiol, 2015, 44(5):687-694.
[18] Kandemir O, Karaku K, Katrancio lu O, et al. Semi-quantitative investigation of primary tumor and bone metastasis in lung cancer patients using the PET-CT approach[J]. Int J ClinExp Med,2014, 7(9):2624-2631.
[19] Lio E, Aisner DL, Askin FB, et al. Giant pulmonary chondroid hamartoma:imaging and pathology correlation of a rare tumor demonstrated with bone scintigraphy and 18F-FDG PET/CT[J].ClinNucl Med, 2015, 40(1):79-81.
[20] Chen YR, Kuo YC, Hsu CN, et al. False suggestion of malignant transformation of benign bone tumor by 18F-FDG PET/CT:A potential pitfall[J]. ClinNucl Med, 2016, 41(10):774-775.