目的分析磁共振成像(Magnetic Resonance Imaging，MRI)结合血清碱性 磷酸酶(alkaline phosphatase，ALP)、 乳酸脱氢酶(lactic dehydrogenase， LDH)检测在骨肉瘤早期诊断及预后评估的 临床价值。方法 选取2012年1月-2013年 2月我院收治的疑似早期骨肉瘤患者70例 纳入研究，均行MRI诊断与血清ALP、LDH 检测，以手术病理结果为“金标准”，比 较MRI、血清ALP与LDH、MRI结合血清ALP 与LDH各自的诊断灵敏度、特异度、准确 性，并将确诊为骨肉瘤患者依据治疗前血 清ALP、LDH水平差异分为高表达组与正 常组，比较2组5年生存率。结果 MRI诊 断灵敏度83.87%，特异度75.00%，准确 性82.86%，Kappa值为0.41；血清ALP与 LDH检测灵敏度79.03%，特异度87.50%， 准确性80.00%，Kappa值为0.40；MRI结 合血清ALP、LDH检测灵敏度95.16%，特 异度87.50%，准确性94.29%，Kappa值为 0.75；MRI结合血清ALP、LDH检查灵敏 度、准确性均明显高于MRI、血清ALP与 LDH检查方式(P＜0.05)；血清ALP与LDH正 常表达组5年生存率明显高于高表达组(P ＜0.05)。结论 MRI结合血清ALP、LDH对 骨肉瘤早期诊断具有较高准确性，血清 ALP、LDH水平检测能为患者预后评估提供 重要依据。

Objective To analyze the clinical value of magnetic resonance imaging (MRI) combined with detection of serum alkaline phosphatase (ALP) and lactic dehydrogenase (LDH) in early diagnosis and prognosis assessment of osteosarcoma. Methods A total of seventy patients with suspected early osteosarcoma who were admitted to the hospital from January 2012 to February 2013 were enrolled in the study. All patients underwent MRI scan and detection of serum ALP and LDH. With surgical pathological results as the golden standard, the diagnostic sensitivity, specificity and accuracy rates of MRI, serum ALP and LDH, and MRI combined with serum ALP and LDH were compared. Patients with osteosarcomas were divided into the high expression group and the normal group according to serum ALP and LDH levels, and the 5-year survival rate was compared between the two groups. Results The diagnostic sensitivity, specificity, accuracy and Kappa value of MRI were 83.87%, 75.00%, 82.86% and 0.41. Those of serum ALP and LDH were 79.03%, 87.50%, 80.00% and 0.40. Those of MRI combined with serum ALP and LDH were 95.16%, 87.50%, 94.29% and 0.75. The sensitivity and accuracy of MRI combined with serum ALP and LDH were significantly higher than those of MRI or serum ALP and LDH (P<0.05). The 5-year survival rate of the normal expression group was significantly higher than that of the high expression group (P<0.05). Conclusion MRI combined with serum ALP and LDH is with high accuracy in early diagnosis of osteosarcoma. Serum ALP and LDH levels can provide important evidence for evaluation of the prognosis.