软组织血管瘤与神经鞘瘤影像学鉴别诊断  

Imaging differential diagnosis of soft tissue hemangioma and soft tissue schwannoma

作　　者：连欣怡 纪清连[1] 付海花 刘吉华[1] LIAN Xinyi;JI Qinglian;FU Haihua;LIU Jihua(Department of Radiology,the Affiliated Hospital of Qingdao University,Qingdao,Shandong Province 266003,China;Linqu County Health Bureau,Linqu,Shandong Province 262600,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266003 [2]临朐县卫生健康局,山东临朐262600

出　　处：《实用放射学杂志》2022年第11期1836-1839,共4页Journal of Practical Radiology

摘　　要：目的探讨软组织血管瘤与神经鞘瘤的影像学鉴别诊断价值.方法回顾性分析经病理证实的50例软组织血管瘤和51例软组织神经鞘瘤的影像学表现,对病灶的影像学征象差别进行单因素分析,具有统计学意义的指标再进行多因素回归分析,建立Logistic回归模型.判定Logistic回归模型的拟合优度检验采用Hosmer-Lemeshow检验,采用受试者工作特征(ROC)曲线评价其诊断效能.结果2组病例在最大径(>5cm)、边界模糊、不规则形态、非边缘钙化、类囊变区、内部脂肪、靶征、神经出入征、包膜、条带状影方面的差异有统计学意义(P<0.05).多因素回归分析进入Logistic模型的5个特征分别为:不规则形态[优势比(OR)=25.842,95%置信区间(CI)1.999~334.152]、类囊变区(OR=0.038,95%CI0.002~0.847)、内部脂肪(OR=24.340,95%CI 1.197~495.014)、靶征(OR=0.009,95%CI0~0.764)、包膜(OR=0.006,95%CI0~0.146).Hosmer Lemeshow检验的显著性水平为0.999.ROC曲线的曲线下面积为0.986(P<0.01).敏感度为94.0%,特异度为94.1%,阳性预测值为94.0%,阴性预测值为94.1%.结论不规则形态、类囊变区、内部脂肪、靶征和包膜是鉴别软组织血管瘤和神经鞘瘤的5个特征性预测指标,Logistic回归模型对鉴别具有较高的敏感性和特异性.Objective To evaluate the imaging differential diagnosis value in hemangioma and schwannoma of soft tissue.Methods The imaging findings of 50 cases of soft tissue hemangioma and 51 cases of soft tissue schwannoma confirmed by pathology were analyzed retrospectively.Univariate analysis was carried out for the differences of imaging signs of lesions.Multivariate regression analysis was carried out for the indicators with statistical significance,and Logistic regression model was established.Hosmer-Lemeshow test was used to determine the goodness of fit of Logistic regression model,and receiver operating characteristic(ROC)curve was used to evaluate its diagnostic efficacy.Results There were significant differences between the two groups in terms of maximum diameter(>5 cm),fuzzy boundary,irregular shape,non-marginal calcification,thylakoid zone,internal fat,target sign,nerve access sign,capsule and banded shadow(P<0.05).The 5 features involved into the Logistic model by multivariate regression analysis were:irregular shape[odds ratio(OR)=25.842,95%confidence interval(CI)1.999-334.152],thylakoid zone(OR=0.038,95%CI0.002-0.847),internal fat(OR=24.340,95%CI1.197-495.014),target sign(OR=0.009,95%CI 0-0.764),and capsule(OR=0.006,95%CI 0-0.146).Hosmer-Lemeshow test had a significant level of 0.999.The area under the curve was 0.986(P<0.01).The sensitivity,specificity,positive predictive value and negative predictive value were 94.0%,94.1%,94.0%and 94.1%respectively.Conclusion Irregular shape,thylakoid zone,internal fat,target sign and capsule are the characteristic predictors for differentiating hemangioma and schwannoma of soft tissue.Logistic regression model has high sensitivity and specificity in the differentiation.

关 键 词：血管瘤 神经鞘瘤 计算机体层成像 磁共振成像 

分 类 号：R732.2[医药卫生—肿瘤] R730.264[医药卫生—临床医学] R814.42R445.2