Diagnostic value of dynamic contrast-enhanced CT for musculoskeletal tumor and phymatoid lesion

Objective:To evaluate the diagnostic value of time-density curve from dynamic contrast-enhanced CT scan in musculoskeletal tumors and phymatoid lesions.Materials and Methods:Forty musculoskeletal tumors and phymatoid lesions underwent CT plain scan and dynamic contrast-enhanced scan.The related software inside CT apparatus depicted time-density curve of lesions and healthy-side counterparts.Contrast enhancement amplitude(A) and curve gradient rate(K) were both measured.Rate of enhancement amplitude(RA) for lesion versus counterpart was also calculated.Curve form were analyzed and were divided into two types.Results:There was statistically significant difference between benign and malignant lesion in A,RA,curve type(P 0 05).The percentages of benign lesions with A≤20Hu and malignant lesions with A 20Hu were 66 6% and 72 7% respectively.There was statistically significant difference between benign lesions with A≤20Hu and malignant lesions with A 20Hu(Fishers exact test,P=0 024).The percentages of benign lesions with RA≤2 5 and malignant lesions with RA 2 5 were 75% and 71 44% respectively.The difference was also very significant between benign lesions with RA≤2 5 and malignant lesions with RA 2 5 (Fishers exact test,P=0 003).Among benign lesion curves,66 7% (12/18) appeared slow ascent type (Ⅱ type),however,86 4%(19/22) malignant curves appeared early sharp ascent and later relative stability type(Ⅰ type).There was very significant difference in two kinds of curve percentage between benign and malignant lesions(Fishers exact test,P=0 001).Conclusions:Time-density curve from the dynamic contrast-enhanced CT scan provides a useful and practicable method for differentiating benign and malignant musculoskeletal tumors and phymatoid lesions.