超声造影与增强MRI在眼眶肿瘤病中的诊断价值

发布时间：2018-05-03 01:37

本文选题：眼眶肿瘤 + 超声造影　；参考：《武汉大学学报(医学版)》2014年05期

【摘要】：目的:比较超声造影(CEUS)与增强磁共振扫描两种检查方法在眼眶肿瘤中的诊断价值,并探讨两者增强模式对眼眶肿瘤良恶性鉴别诊断的价值。方法:选取我院眼科2011-2013年62例眼眶占位患者均行超声造影和MRI增强检查并分别做出诊断。以病理诊断为标准,计算两种检查方法在眼眶肿瘤中的诊断符合率、敏感性及特异率;然后依照病理结果将62例患者分为良恶性两组,比较两种检查方法增强强度在眼眶肿瘤良恶性组别中表达的差异性,分析增强模式的不同对良恶性鉴别的价值;应用Sonoliver软件分析所有62例眼科超声造影的病例,处理得到肿瘤造影时间-强度曲线(TIC),获取造影剂达到时间(AT)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(mTT)、半洗出时间进行定量分析;应用卡方检验及非参检验,P0.05为差异有统计学意义。结果:1在对62列眼眶肿瘤的患者诊断中,CEUS与增强MRI的诊断符合率无差异,分别为82.3%和80.6%;敏感性分别为64.7%与70.2%,特异度分别为88.9%与84.4%,两者差异有统计学意义(P0.05)。2在增强强度的比较中,CEUS增强强度在良恶性组别中分布存在不同(P0.05);MRI增强强度在良恶性组别中分布无明显差异。3根据TIC获取的参数中:AT、RT、TTP、半洗出时间等参数在良恶性肿瘤分组中存在差异(P0.05);而mTT在两者之间无明显差异。结论:超声造影在眼眶肿瘤的诊断符合率与MRI的表现无明显差异,而敏感性低于增强MRI,特异度高于增强MRI;超声造影的增强强度及造影时间-强度曲线在良恶性分组中存在明显差异,有利于进一步鉴别眼眶肿瘤的良恶性。在无法行增强MRI检查的病例中,超声造影作为一种补充检查方法有一定的临床价值。
[Abstract]:Objective: to compare the diagnostic value of contrast-enhanced magnetic resonance imaging (CEUs) and contrast-enhanced magnetic resonance imaging (MRI) in orbital tumors and to explore the value of the two enhancement modes in differential diagnosis of orbital tumors. Methods: from 2011 to 2013, 62 orbital space occupying patients in our hospital were examined by contrast-enhanced ultrasonography and MRI respectively. According to the criteria of pathological diagnosis, the diagnostic coincidence rate, sensitivity and specificity of the two methods in orbital tumors were calculated, and 62 patients were divided into benign and malignant groups according to the pathological results. To compare the difference of enhancement intensity between the two methods in the benign and malignant groups of orbital tumors, to analyze the value of different enhancement models in differentiating benign and malignant tumors, and to analyze all 62 cases of ophthalmic contrast-enhanced ultrasonography with Sonoliver software. The time-intensity curve of tumor angiography was obtained by TIC-TICT, the time of rising, the time of reaching peak, the average transit time and the time of half-washing out were obtained, and the difference was statistically significant by using chi-square test and non-reference test (P0.05). Results there was no difference between CEUs and enhanced MRI in the diagnosis of 62 orbital tumors. The sensitivity was 64.7% and 70.2%, and the specificity was 88.9% and 84.4%, respectively. The difference between them was statistically significant. There was no significant difference in distribution among sex groups. 3 according to the parameters obtained by TIC, there was no significant difference in the parameters of TIC, such as half washing time and so on, in the grouping of benign and malignant tumors (P 0.05), but there was no significant difference in mTT between the two groups. Conclusion: the diagnostic coincidence rate of contrast-enhanced ultrasonography in orbital tumors is not significantly different from that of MRI. The sensitivity was lower than that of enhanced MRI, and the specificity was higher than that of enhanced MRI.The enhanced intensity and time-intensity curve of contrast-enhanced ultrasonography were significantly different in benign and malignant groups, which was helpful to further distinguish benign and malignant orbital tumors. Contrast-enhanced MRI can be used as a supplementary examination method in patients who can not be examined by contrast-enhanced ultrasonography.
【作者单位】：武汉大学人民医院超声影像科;湖北省黄冈市中心医院超声影像科;武汉大学人民医院眼科;
【分类号】：R739.7;R445.2

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