腺泡状软组织肉瘤与肌内毛细血管瘤的超声影像学特征及其超声诊断模型建立  

Analysis of ultrasound images features and diagnostic model establishment of alveolar soft part sarcoma and intramuscular capillary-type hemangiomas

作　　者：胡文笳 王朝晗 吴刚 郭晓楠 董长宪 康红 刘秋雨 袁建军 杨筱 Hu Wenjia;Wang Zhaohan;Wu Gang;Guo Xiaonan;Dong Changxian;Kang Hong;Liu Qiuyu;Yuan Jianjun;Yang Xiao(Department of Ultrasound,Henan Provincial People′s Hospital,Zhengzhou University People′s Hospital,Henan University People′s Hospital,Zhengzhou 450003,China;Department of Hemangioma,HenanProvincial People′s Hospital,Zhengzhou University People′s Hospital,Henan University People′s Hospital,Zhengzhou 450003,China;Department of Pathology,Henan Provincial People′s Hospital,Zhengzhou University People′s Hospital,Henan University People′s Hospital,Zhengzhou 450003,China;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beijing 100730,China)

机构地区：[1]河南省人民医院,郑州大学人民医院,河南大学人民医院超声医学科,郑州450003 [2]河南省人民医院,郑州大学人民医院,河南大学人民医院血管瘤科,郑州450003 [3]河南省人民医院,郑州大学人民医院,河南大学人民医院病理科,郑州450003 [4]中国医学科学院,北京协和医学院,北京协和医院超声医学科,北京100730

出　　处：《中华医学杂志》2024年第8期608-613,共6页National Medical Journal of China

基　　金：中央高水平医院临床科研业务费(2022-PUMCH-B-064)

摘　　要：目的分析超声中腺泡状软组织肉瘤(ASPS)与肌内毛细血管瘤(ICTH)的影像学特征,构建诊断模型。方法横断面研究。将2005年1月至2023年2月河南省人民医院收治的52例经病理证实的ASPS和ICTH患者纳入研究,其中男28例,女24例,年龄(20.7±15.1)岁。根据病灶病理类型分为ASPS组和ICTH组。回顾性收集患者的临床资料,将单因素分析中有意义的指标纳入回归分析中进行筛选,综合考虑临床意义和统计学意义,选取符合条件的指标纳入回归分析。采用二元logistic回归分析来筛选区分ASPS及ICTH病理类型的因素,建立诊断模型。采用受试者工作特征(ROC)曲线下面积(AUC)评估诊断模型鉴别ASPS和ICTH的效能。结果ASPS组患者20例,男10例,女10例,年龄(26.9±13.5)岁;ICTH组患者32例,男18例,女14例,年龄(16.8±15.0)岁。ASPS组与ICTH组患者年龄差异有统计学意义(P<0.05),两组超声影像学特征中“边界清楚”“病灶周边分叶”“病灶内部纤细血管平直走形”“病灶内液化”“周边粗大血管”和“周边肌纤维中断”方面差异均有统计学意义(均P<0.001)。选取具有临床意义和统计学意义的变量作为自变量,二元logistic回归分析显示,周边肌纤维中断(OR=97.358,95%CI:6.833~1387.249)和内部纤细血管平直走形(OR=0.052,95%CI:0.003~0.921)是区分ASPS及ICTH病理类型的相关因素,采用“周边肌纤维中断”和“内部纤细血管平直走形”两个超声影像特征建立诊断模型,“周边肌纤维中断”诊断模型灵敏度为81.3%,特异度为95.0%,AUC为0.811(95%CI:0.761~0.954);“内部纤细血管平直走形”诊断模型灵敏度为90.0%,特异度为96.9%,AUC为0.934(95%CI:0.830~0.984);“周边肌纤维中断”和“内部纤细血管平直走形”联合诊断模型灵敏度为96.9%,特异度为90.0%,AUC为0.974(95%CI:0.877~0.999)。结论超声检查可用于鉴别ASPS与ICTH,采用“周边肌纤维中断”和“内部纤细血管平直走形”Objective The ultrasonography features of alveolar soft part sarcoma(ASPS)and intramuscular capillary-type hemangiomas(ICTH)were analyzed,and the diagnostic model of ASPS was established.Methods A cross-sectional study was carried out.The clinical data of 52 patients[28 males and 24 females,aged(20.7±15.1)years]with pathologically confirmed ASPS and ICTH admitted to People′s Hospital of Henan Province from January 2005 to February 2023 were included in the study.According to pathological types,the patients were divided into ASPS group and ICTH group.Clinical data of patients were retrospectively collected,and meaningful indicators in the univariate analysis were included in the regression analysis for screening.After comprehensive consideration of clinical significance and statistical significance,eligible indicators were selected for inclusion in the regression analysis.Binary logistic regression analysis was used to screen the factors that distinguished the pathological types of ASPS and ICTH,and the diagnostic model was established.The area under receiver operating characteristic(ROC)curve(AUC)was used to evaluate the diagnostic effectiveness of the diagnostic model in distinguishing ASPS from ICTH.Results There were 20 patients in ASPS group,10 males and 10 females,aged(26.9±13.5)years,and 32 patients in ICTH group,18 males and 14 females,aged(16.8±15.0)years.The age difference between the ASPS group and the ICTH group was statistically significant(P<0.05),and there were statistically significant differences in the ultrasound imaging features of"clear boundary""peripheral lobe""thin blood vessels inside the lesion are straight and out of shape""intra-lesion liquification""peripheral thick blood vessels"and"peripheral muscle fiber disruption"between the two groups(all P<0.001).Variables with clinical and statistical significance were selected as independent variables.Binary logistic regression analysis showed that peripheral muscle fiber interruption(OR=97.358,95%CI:6.833-1387.249)and internal thin blood

关 键 词：肉瘤 软组织腺泡状 肌内毛细血管瘤 超声声像图 

分 类 号：R445.1[医药卫生—影像医学与核医学] R738.6[医药卫生—诊断学]