超声评分法在体表高分化脂肪肉瘤和脂肪瘤鉴别诊断中的应用价值  

The value of ultrasonography scoring system for differential diagnosis of well-differentiated superficial liposarcomas and lipoma

作　　者：邱春花[1] 萧淑宜[1] 区文财[1] 董盖英 柳建华[1] QIU Chunhua;XIAO Shuyi;OU Wencai;DONG Gaiying;LIU Jianhua(Department of Ultrasound,Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院超声医学科,广州510180

出　　处：《广州医药》2022年第3期27-31,共5页Guangzhou Medical Journal

基　　金：广州市卫生健康科技项目(20211A010008)。

摘　　要：目的探讨超声评分法在体表高分化脂肪肉瘤(WDLPS)和良性脂肪瘤(LP)鉴别诊断中的价值,为两者的鉴别诊断和治疗方式选择提供依据。方法回顾性分析经病理证实的14例(共15个肿块)体表WDLPS和37例(共40个肿块)LP临床资料及超声声像图特征,比较2组患者的发病年龄、性别、发病部位、肿块长径、短/长径比、肿块形态、边界、有无包膜、内部回声、回声分布、位置及血流分级等指标。筛选出有统计学差异指标,绘制ROC曲线,计算评分系统的诊断效能。结果WDLPS和LP患者在年龄、肿块长径、短/长径比值、有无包膜、位置以及血流分级6个指标有统计学差异(P<0.05),对以上6个指标赋予0或1分建立病灶评分系统,总分0~6分。计算不同分值对WDLPS的诊断效能,以总分≥3分时诊断效能最高,灵敏度86.7%,特异度77.5%,正确率80%,阳性预测值59.1%,阴性预测值93.9%。结论基于超声图像特征的评分方法在总分≥3分时,对术前鉴别WDLPS和LP具有较好的诊断效能,能够为临床治疗方案选择提供重要参考依据,值得推广应用。Objective To evaluate the value of ultrasonography scoring system in differential diagnosis of well-differentiated liposarcomas(WDLPS)and benign lipoma(LP),and to provide evidence for the differential diagnosis and treatment choice.Methods Fourteen WDLPS cases(total of 15 masses)and 37 LP cases(total of 40 masses)were diagnosed by surgical histopathology,which clinical data and the ultrasound images were analyzed retrospectively.The parameters including age,gender,region,mass length,length/width ratio,shape,margin,envelope echoes,echogenicity,texture,location,blood flow were compared between the groups above.A scoring system was established by analyzing the parameters with statistical differences,and the ROC curve was plotted to calculate the best cut-off value and evaluate the diagnostic efficiency of the scoring system.Results There were statistically significant differences between two groups in the following six parameters:age,mass length,length/width ratio,envelope echoes,location,blood flow(P<0.05).The scoring system was established by assigning 0 or 1 point to each factor,and the total score was 0~6 points.The highest diagnostic efficiency of WDLPS was observed at the cut-off value≥3.The sensitivity,specificity,accuracy,the positive predictive value and the negative predictive value was 86.7%,77.5%,80%,59.1%,93.9%respectively.Conclusions The ultrasonography-based scoring system has a better diagnostic efficacy in differentiating WDLPS and LP,which can provide an important reference basis for the selection of clinical treatment,and is worthy of promotion and application.

关 键 词：超声 高分化脂肪肉瘤 脂肪瘤 

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]