CAJ | 학술논문

目的：探讨病变水肿区纵行分布的对称性在骨化性肌炎鉴别诊断中的应用价值。方法回顾性分析2008年3月至2012年6月，北京积水潭医院经手术或穿刺病理证实的15例早、中期骨化性肌炎和17例骨、软组织肿瘤及感染性病变，划分为骨化性肌炎组与非骨化性肌炎组，32例平均年龄(33.1±17.5)岁。分别测量病灶中心与周围水肿区上缘(远地端)/水肿区下缘(近地端)距离的比值，并进行统计学分析。采用非参数法构建受试者作用曲线，并计算早、中期骨化性肌炎的敏感度和特异度。结果在15例早、中期骨化性肌炎组病变中，病变中心与周围水肿区上/下缘距离的比值为0.62±0.24，偏离1；17例非骨化性肌炎组病变中，病变中心与周围水肿区上/下缘距离的比值为0.99±0.06，接近1；两组组间比较，差异有统计学意义( P＜0.001)。以0.855为临界点，诊断早、中期骨化性肌炎，敏感度为86.7%，特异度为100%。结论早、中期骨化性肌炎病灶中心与病变水肿区上、下边缘距离比值偏离1，病变水肿区纵行分布不对称，在早、中期骨化性肌炎的鉴别诊断中具有一定的参考价值，有助于提高定性诊断正确率。
목적：탐토병변수종구종행분포적대칭성재골화성기염감별진단중적응용개치。방법회고성분석2008년3월지2012년6월，북경적수담의원경수술혹천자병리증실적15례조、중기골화성기염화17례골、연조직종류급감염성병변，화분위골화성기염조여비골화성기염조，32례평균년령(33.1±17.5)세。분별측량병조중심여주위수종구상연(원지단)/수종구하연(근지단)거리적비치，병진행통계학분석。채용비삼수법구건수시자작용곡선，병계산조、중기골화성기염적민감도화특이도。결과재15례조、중기골화성기염조병변중，병변중심여주위수종구상/하연거리적비치위0.62±0.24，편리1；17례비골화성기염조병변중，병변중심여주위수종구상/하연거리적비치위0.99±0.06，접근1；량조조간비교，차이유통계학의의( P＜0.001)。이0.855위림계점，진단조、중기골화성기염，민감도위86.7%，특이도위100%。결론조、중기골화성기염병조중심여병변수종구상、하변연거리비치편리1，병변수종구종행분포불대칭，재조、중기골화성기염적감별진단중구유일정적삼고개치，유조우제고정성진단정학솔。
Objective To investigate the value of the longitudinal distribution symmetry assessment of the edema zone in the differential diagnosis of myositis ossiifcans ( MO ).Methods From March 2008 to June 2012, 15 patients with early or medium-term MO and 17 patients with bone or soft tissue tumors and infectious diseases conifrmed by surgical pathology or biopsy were adopted, whose clinical data were retrospectively analyzed. All the patients were divided into two groups, including the MO group (n=15 ) and the non-myositis ossificans ( NMO ) group (n=17 ). The superior and posterior fringes of the edema zone were identiifed, and the ratio of their distances from the center of the ossiifed focus was measured. All the data were analyzed statistically. A nonparametic method was employed to generate a receiver operating characteristic ( ROC ) curve.Results The ratios of the superior and posterior fringes of the edema zone were 0.62±0.24 in the MO group and 0.99±0.06 in the NMO group. All the data were analyzed between the two groups by independent samplest-test, and the differences were statistically signiifcant (P<0.001 ). With 0.855 as the critical point, the sensitivity was 86.7% and the speciifcity was 100% in the diagnosis of early and medium-term MO.Conclusions The ratio of the superior and posterior fringes of the edema zone from the center of the ossiifed focus is not equal to 1 in the patients with early and medium-term MO. The longitudinal distribution symmetry assessment of the edema zone may supply some referential information for the differential diagnosis of early and medium-term MO, which is helpful to improve the accuracy of qualitative diagnosis.