多层螺旋CT鉴别诊断肾上腺外髓样脂肪瘤与去分化脂肪肉瘤的应用价值  

作　　者：华建军 应明亮[1] 杨文婷 胡亮[1] 

机构地区：[1]浙江大学附属金华医院,321099

出　　处：《浙江临床医学》2022年第6期898-900,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨多层螺旋CT(MSCT)鉴别诊断肾上腺外髓样脂肪瘤(EAML)与去分化脂肪肉瘤(DDL)的应用价值。方法回顾性分析经病理证实的10例EAML和14例DDL病例资料,分析两种肿瘤病变的坏死囊变、包膜、浸润、动静脉期绝对强化值及最大强化程度(CEmax)等,影像学征象在鉴别诊断中的敏感度和特异度通过绘制ROC曲线并计算曲线下面积(AUC)进行评价。结果EAML10例均无浸润、囊变,9例包膜完整;DDL12例有浸润,9例坏死囊变,12例包膜不完整或无包膜,组间差异均有统计学意义(P_(均)<0.05);敏感度分别为100%、100%、90%,特异度分别为85.7%、64.2%、85.7%,AUC值分别为0.929、0.821、0.879。EAML与DDL的动、静脉期绝对强化值及CEmax比较,差异均有统计学意义(P_(均)<0.05),敏感度分别为90%、50%、50%,特异度分别为64.2%、92.8%、92.8%,AUC值分别为0.800、0.768、0.768。结论MSCT动态增强扫描对EAML与DDL的鉴别诊断有较高应用价值。Objective To explore the application value of multi-slice computer tomography(MSCT)in differential diagnosis of extra-adrenal myelolipoma(EAML)and dedifferentiated liposarcoma(DDL).Methods The data of 10 cases of EAML and 14 cases of DDL confirmed by pathology were analyzed retrospectively.The necrotic cystic degeneration,capsule,infiltration,absolute enhancement value,and maximum enhancement degree(CEmax)in arterial and portal vein phases were analyzed respectively.The sensitivity and specificity of imaging features in differential diagnosis were evaluated by plotting ROC curves and calculating the area under the curve(AUC).Results All the 10 cases of EAML had no sign of infiltration and cystic degeneration,and 9 cases had complete capsule.Twelve cases of DDL had signs of infiltration,9 cases had necrotic and cystic degeneration,and 12 cases had incomplete or no obvious capsule.The difference were all statistically significant(all P<0.5),the sensitivity were 100%,100%,90%,the specificity were 85.7%,64.2%,85.7%,and AUC were 0.929,0.821,0.879,respectively.The difference of absolute enhancement value in arterial and venous phase and the CEmax between EAML and DDL were statistically significant(all P<0.5),the sensitivity were 90%,50%,50%,the specificity were 64.2%,92.8%,92.8%,and AUC were 0.800,0.768,0.768,respectively.Conclusion MSCT dynamic enhanced scanning has high value in differential diagnosis between EAML a nd DDL.

关 键 词：肾上腺外髓样脂肪瘤 去分化型脂肪肉瘤 多层螺旋CT 鉴别诊断 

分 类 号：R73[医药卫生—肿瘤]