Computed tomography of pulmonary metastases from osteosarcoma: The less poor technique. A study of 51 patients with histological correlation
Computed tomography of pulmonary metastases from osteosarcoma: The less poor technique. A study of 51 patients with histological correlation
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DOI：
10.1023/a:1013103511633
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发表时间：
2001-01-01
影响因子：
50.5
通讯作者：
Alvegard, TA
中科院分区：
文献类型：
--
作者：
Picci, P;Vanel, D;Alvegard, TA
背景：目的是评估计算机断层扫描 (CT) 在骨肉瘤肺部分期中的准确性。患者和方法：51 名患有骨肉瘤且最初 CT 被认为转移至胸部的患者接受了肺部手术。由两名高级放射科医生组成的两个小组独立审查了所有 CT 检查。他们的结果与组织学研究进行了比较。结果：对 119 个 CT 进行了审查。两个团队在初始CT上发现了247个和268个结节，在术前CT上发现了143个和146个结节。组织学研究证实 29 名患者存在转移结节。切除并研究了 204 个结节。一百九个是转移瘤。 22 名无转移的患者切除了 53 个阴性结节。在 29 名转移患者中，151 个结节被切除，42 个为非转移结节。 “结节”的阳性预测值为 53%，“患者”的阳性预测值为 57%。手术时有 1 个结节的 13 例患者中，只有 4 例发生转移，但所有超过 7 个结节的患者均发生转移。46 例具有多个可用 CT 的结果表明，良性病变中结节数量没有变化更为常见。其他标准显示无显着差异。结论：CT阳性预测价值有限，但由于手术是治愈转移患者的唯一方法，因此在找到更具体的方法之前，CT仍将作为参考技术。
Background: The purpose is to evaluate the accuracy of computed tomography (CT) in the pulmonary staging of osteosarcoma.Patients and methods: Fifty-one patients presenting with osteosarcoma and at initial CT considered metastatic to the chest had lung surgery. Two teams of two senior radiologists independently reviewed all CT examinations. Their results were compared to the histological studies.Results: One hundred nineteen CT's were reviewed. The 2 teams found 247 and 268 nodules on the initial, and 143 and 146 nodules on the preoperative CT. Histological studies confirmed metastatic nodules in 29 patients. Two hundred four nodules were excised and studied. One hundred nine were metastases. The 22 patients without metastases had 53 negative nodules removed. In the 29 patients with metastases, 151 nodules were removed, and 42 were non-metastatic. The positive predictive value was 53% with regard to 'nodules', and 57% with regard to 'patients'. Only 4 out of 13 patients with one nodule at surgery were metastatic, but all patients with more than 7 nodules were metastatic.The 46 cases with several available CT's, showed that no change in the number of nodules was more frequent in benign lesions. Other criteria revealed no significant difference.Conclusion: CT positive predictive value is limited, but as surgery is the only way to cure metastatic patients, CT will still be used as the reference technique until a more specific approach can be found.