CAJ | 학술논문

目的：通过对100例病理证实肌骨系统肿瘤所致软组织肿块的能谱CT图像分析,探讨能谱CT在肌骨系统肿瘤良恶性鉴别中的应用价值。方法对 MR扫描显示有软组织肿块的100例待手术肌骨系统肿瘤病例,进行 CT 能谱扫描及图像后处理。将感兴趣区置于软组织病变密度均匀的实性区域,避开坏死、囊变、出血及钙化区,设备自动生成 keV-CT 值曲线。根据手术病理结果,将患者分为良性组(38例)、交界组(10例)、恶性组(49例)和脂肪病组(3例)(因其曲线呈负值弓背向上形与前三者明显不同,予以单独研究),计算每组能谱曲线平均斜率值：斜率(K)=(HU 40 keV-HU 80 keV)/40。采用Kruskal-Wallis 秩和检验进行统计学分析。结果良性组的曲线平均斜率为0.75±0.30,呈缓慢下降型,恶性组曲线平均斜率为1.64±1.00,呈速降型,交界组的斜率介于两者之间为1.34±0.45。良性组斜率小于恶性组斜率(P<0.05),良性组斜率小于交界性组斜率(P<0.05)。3例脂肪瘤平均斜率为-2.00。结论能谱曲线对鉴别软组织肿块的良恶性有一定作用。负值弓背向上形曲线是含较多脂肪成分肿瘤的特征。
목적：통과대100례병리증실기골계통종류소치연조직종괴적능보CT도상분석,탐토능보CT재기골계통종류량악성감별중적응용개치。방법대 MR소묘현시유연조직종괴적100례대수술기골계통종류병례,진행 CT 능보소묘급도상후처리。장감흥취구치우연조직병변밀도균균적실성구역,피개배사、낭변、출혈급개화구,설비자동생성 keV-CT 치곡선。근거수술병리결과,장환자분위량성조(38례)、교계조(10례)、악성조(49례)화지방병조(3례)(인기곡선정부치궁배향상형여전삼자명현불동,여이단독연구),계산매조능보곡선평균사솔치：사솔(K)=(HU 40 keV-HU 80 keV)/40。채용Kruskal-Wallis 질화검험진행통계학분석。결과량성조적곡선평균사솔위0.75±0.30,정완만하강형,악성조곡선평균사솔위1.64±1.00,정속강형,교계조적사솔개우량자지간위1.34±0.45。량성조사솔소우악성조사솔(P<0.05),량성조사솔소우교계성조사솔(P<0.05)。3례지방류평균사솔위-2.00。결론능보곡선대감별연조직종괴적량악성유일정작용。부치궁배향상형곡선시함교다지방성분종류적특정。
Objective To explore the value of spectral curve in the differential diagnosis of benign and malignant tumor of the musculoskeletal system.Methods 100 patients with mass of the musculoskeletal system which were found by MRI underwent Dis-covery HD750 Gemstone CT scan ,and the images acquired were processed.Areas with homogenous density which did not contain necrosis,cyst,hemorrhage and calcification were chosen as region of interest(ROI).The optimal Kev on single energy images was selected,then the Kev-CT curve was automatically generated.All 100 patients proved by histological examination were divided into four groups,38 cases were as group A with benign tumor,10 cases as group B with borderline tumor,49 cases as group C with ma-lignant tumor and 3 cases of lipoma(that were analyzed separately since its curve was arc shaped).Average slope rate of every group was calculated according to the formula:K=(HU40keV-HU80keV)/40.Kruskal Wallis test was applied for statistical analysis,P value of less than 0.05 was considered statistical significant.Results The spectral curve of group C was sharply falling type with a mean slope rate of 1.64±1.00,that of group A was gradually falling type with a mean slope rate of 0.75±0.30,and that of group B was 1.34±0.45.The difference of slope rate between group A and C and between A and B were of statistical significance(P<0.05).The spectral curve of 3 lipomas showed arc shaped rising type with a mean slope rate of-2.00.Conclusion Spectral curve is useful in the differential diagnosis of benign and malignant tumor of the musculoskeletal system.Arc shaped curve is a specific sign for tumors containing abundant fat.