MRI在新生儿肾上腺病变中的诊断价值分析  

Analysis of the diagnostic value of MRI in neonatal adrenal lesion

作　　者：周花 李清水 温天生 郭俊 ZHOU Hua;LI Qingshui;WEN Tiansheng;GUO Jun(Department of Radiology,Ganzhou Women and Children's Health Care Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市妇幼保健院放射影像科,江西赣州341000

出　　处：《中国当代医药》2025年第5期113-116,121,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212366)。

摘　　要：目的分析核磁共振扫描(MRI)在新生儿肾上腺病变中的诊断价值。方法选取2020年1月至2023年12月赣州市妇幼保健院诊疗的60例经评估症状与表现,并经超声判定可能疑似肾上腺病变的新生儿患儿作为研究对象。所有患儿符合手术适应证并接受手术治疗,术前接受超声、MRI检查,以手术结果作为金标准,分析MRI检查对新生儿肾上腺病变的诊断价值与对不同肾上腺病变类型的鉴别诊断价值。结果60例高度疑似肾上腺病变患儿,最终经手术明确肾上腺病变34例,占比56.67%,包括肾上腺出血27例,肾上腺增生3例,肾上腺囊肿2例,肾上腺畸胎瘤2例。肾上腺出血患儿ADC值小于非肾上腺出血患儿,差异有统计学意义(P<0.05)。以手术结果为金标准,MRI诊断新生儿肾上腺病变的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为94.12%(32/34)、88.46%(23/26)、91.67%(55/60)、91.43%(32/35)、92.00%(23/25),且诊断结果与金标准结果一致性较强(Kappa=0.830,P<0.001);MRI对新生儿肾上腺病变不同病变类型的检出准确率为91.18%(31/34),与金标准结果一致性较强(Kappa=0.735,P<0.001)。结论MRI对新生儿肾上腺病变的诊断及鉴别诊断价值均相对理想,与手术结果有较好的一致性。Objective To analyze the diagnostic value of magnetic resonance scanning(MRI)in neonatal adrenal diseases.Methods A total of 60 newborn children diagnosed and treated in Ganzhou Women and Children's Health Care Hospital from January 2020 to December 2023 were selected as the study objects,whose symptoms and manifestations were evaluated and who were determined by ultrasound to be suspected of adrenal lesion.All the patients met the surgical indications and received surgical treatment.Preoperative ultrasonography and MRI were performed.The diagnostic value of MRI in neonatal adrenal lesion and differential diagnosis of different types of adrenal lesion were analyzed with surgical results as the gold standard.Results A total of 60 children with highly suspected adrenal lesion,34 cases(56.67%)were confirmed by operation,including 27 cases of adrenal hemorrhage,3 cases of adrenal hyperplasia,2 cases of adrenal cyst and 2 cases of adrenal teratoma.The ADC value in children with adrenal hemorrhage was lower than that in children without adrenal hemorrhage,and the difference was statistically significant(P<0.05).Using surgical results as the gold standard,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MRI in the diagnosis of neonatal adrenal diseases were 94.12%(32/34),88.46%(23/26),91.67%(55/60),91.43%(32/35),92.00%(23/25),respectively.The results of diagnosis were consistent with those of gold standard(Kappa=0.830,P<0.001).The accuracy of MRI in detecting different types of neonatal adrenal lesions was 91.18%(31/34),which was consistent with the gold standard results(Kappa=0.735,P<0.001).Conclusion The value of MRI in the diagnosis and differential diagnosis of neonatal adrenal diseases is relatively ideal,and there is a good agreement with the surgical results.

关 键 词：肾上腺病变 新生儿 核磁共振扫描 诊断 

分 类 号：R586[医药卫生—内分泌]