超声、CT和MRI在眶内海绵状血管瘤诊断中的准确率比较  

Comparison of accuracy of ultrasound,CT and MRI in the diagnosis of intraorbital cavernous hemangiomas

作　　者：许琨 路亚运 赵佳龙 XU Kun;LU Yayun;ZHAO Jialong(Department of Function,the No.4 Hospital of Zhangjiakou,Hebei,Zhangjiakou 075000,China;不详)

机构地区：[1]河北省张家口市第四医院功能科,075000 [2]河北省张家口市第二医院放射科

出　　处：《河北医药》2024年第13期1998-2001,共4页Hebei Medical Journal

基　　金：张家口市科学技术局科技计划项目(编号:2221206D)。

摘　　要：目的 比较超声、CT和MRI在眶内海绵状血管瘤诊断中的准确率。方法 选择2019年3月至2022年3月接诊的疑似眶内海绵状血管瘤患者80例,分别给予超声、CT、MRI检查,将病理活检穿刺诊断结果作为本研究的金标准,对比超声、CT、MRI定性、定位诊断准确率、灵敏度、特异度,Kappa检验超声、CT、MRI定性、定位诊断与金标准的一致性。结果 MRI、超声定性诊断准确率(87.50%、86.25%)、灵敏度(87.50%、87.50%)、特异度(87.50%、75.00%)均高于CT(72.50%、77.78%、25.00%)差异有统计学意义(P<0.05)。MRI定性诊断准确率、灵敏度、特异度与超声比较,差异无统计学意义(P>0.05)。Kappa检验MRI、超声定性诊断与金标准的一致性均较好(Kappa值=0.728、0.752),CT定性诊断与金标准的一致性一般(Kappa值=0.596)。MRI、CT定位诊断准确率(85.00%、82.50%)、灵敏度(85.71%、84.29%)、特异度(80.00%、70.00%)均高于超声(67.50%、72.86%、30.00%),差异有统计学意义(P<0.05),MRI定位诊断准确率、灵敏度、特异度与CT比较,差异无统计学意义(P>0.05)。Kappa检验MRI、CT定位诊断与金标准的一致性均较好(Kappa值=0.734、0.771),超声定位诊断与金标准的一致性一般(Kappa值=0.586)。结论 眶内海绵状血管瘤诊断中,超声定性诊断准确率较高,CT定位诊断准确率较高,MRI定性与定位诊断准确率均较高,可辅助临床制定治疗方案,但价格昂贵,故医生应根据患者实际情况选择最佳的诊断技术。Objective To compare the accuracy of ultrasound,computer tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of intraorbital cavernous hemangiomas.Methods Eighty patients with suspected intraorbital cavernous hemangiomas admitted to our hospital from March 2019 to March 2022 were examined by ultrasound,CT and MRI.With pathology after biopsy as the gold standard,the diagnostic accuracy,sensitivity and specificity of ultrasound,CT and MRI in qualitation and localization of intraorbital cavernous hemangiomas were compared.The kappa statistic was used to test the consistency of the qualitation and localization of intraorbital cavernous hemangiomas diagnosed by ultrasound,CT and MRI versus the gold standard.Results Qualitative diagnostic accuracy(87.50%,86.25%),sensitivity(87.50%,87.50%),and specificity(87.50%,75.00%)of MRI and ultrasound were significantly higher than those of CT(72.50%,77.78%,25.00%,P<0.05).There were no significant differences in the qualitative diagnostic accuracy,sensitivity and specificity between MRI and ultrasound(P>0.05).Qualitative diagnosis by MRI and ultrasonography had a high agreement with the gold standard(Kappa value=0.728,0.752),and the qualitative diagnosis by CT had a fair agreement with the gold standard(Kappa value=0.596).The accuracy of localization(85.00%,82.50%),sensitivity(85.71%,84.29%),and specificity(80.00%,70.00%)of MRI and CT were significantly higher than those of ultrasound(67.50%,72.86%,30.00%,P<0.05),which were comparable between MRI and CT(P>0.05).Localization of intraorbital cavernous hemangiomas diagnosed by MRI and CT had a good agreement with the gold standard(Kappa value=0.734,0.771),and that of ultrasound had a fair agreement with gold standard(Kappa value=0.586).Conclusion Ultrasound has a higher accuracy in the qualitative diagnosis of intraorbital cavernous hemangiomas.CT has a higher accuracy of localization;and MRI has both higher accuracy of qualitative diagnosis and localization.MRI can assist in clinical formulation of treatment plans,alth

关 键 词：超声 CT MRI 眶内海绵状血管瘤 鉴别诊断 

分 类 号：R543[医药卫生—心血管疾病]