最大似然法在鞍区囊性病变MRI诊断中的价值初探  

Maximum likelihood method in MRI diagnosis of cystic lesions involving sellar region

作　　者：王芳芳[1] 张敏鸽[1] 胡粟[1] 张京刚[1] 胡春洪[1] 

机构地区：[1]苏州大学附属第一医院影像科,江苏215006

出　　处：《放射学实践》2012年第3期284-288,共5页Radiologic Practice

摘　　要：目的:探讨最大似然法对囊性垂体瘤、Rathke囊肿和颅咽管瘤这3种鞍区囊性病变的鉴别诊断价值。方法:对经手术病理证实的84例鞍区囊性病变的MRI资料进行回顾性分析,其中囊性垂体瘤40例,颅咽管瘤29例,Rathke囊肿15例。选出10个常见MRI征象,应用最大似然法进行判别,将其结果与常规阅片法的诊断结果进行比较。结果:采用最大似然法84例鞍区囊性病变的诊断符合率分别为囊性垂体瘤87.5%(35/40)、颅咽管瘤93.1%(27/29)和Rathke囊肿80.0%(12/15),总的诊断符合率为88.1%(74/84);常规阅片法诊断符合率分别为囊性垂体瘤80.0%(32/40)、颅咽管瘤86.2%(25/29)和Rathke囊肿60.0%(9/15),总诊断符合率为78.6%(66/84)。最大似然法诊断符合率略高于常规阅片法,但两者差异无显著性意义(χ2=2.74,P=0.098)。结论:最大似然法对鞍区囊性病变的诊断有较高的准确性,可用于指导日常阅片工作,尤其是年轻医师或基层医院医师的工作。Objective：To assess the value of the maximum likelihood method in differentiating the three kinds of cystic lesions involving sellar region including cystic pituitary adenoma,craniopharyngioma and Rathke cleft cyst.Methods：84 patients with cystic lesions involving sellar region proved by pathology were retrospectirvely analyzed,including 40 cases of cystic pituitary adenoma,29 craniopharyngioma and 15 Rathke cleft cyst.Maximum likelihood method was used for analysis.Comparison was made between diagnostic results from the use of traditional method and the maximum likelihood method.Results：The accuracy of diagnosis with the maximum likelihood method was 87.5%（35/40） for cystic pituitary adenoma,93.1%（27/29） for craniopharyngioma,and 80.0%（12/15） for Rathke cleft cyst.The mean accuracy was 88.1%（74/84）.The accuracy of diagnosis with the routine method of cystic pituitary adenoma,craniopharyngioma and Rathke cleft cyst were 80.0%（32/40）,86.2%（25/29） and 60.0%（9/15）;the mean accuracy was 78.6%（66/84）.Although the mean accuracy of former method was higher than the latter,there was no statistical difference（χ2=2.74,P=0.0980.05）.Conclusion：The maximum likelihood method is useful in the diagnosis of sellar regional cystic lesions when compared with the traditional method.Though without statistical significance,it still can be applied in the daily routine study.

关 键 词：鞍区疾病 囊性病变 最大似然法 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]