本文選題：眼眶腫瘤 + 超聲造影��； 參考：《武漢大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2014年05期

【摘要】：目的:比較超聲造影(CEUS)與增強(qiáng)磁共振掃描兩種檢查方法在眼眶腫瘤中的診斷價(jià)值,并探討兩者增強(qiáng)模式對眼眶腫瘤良惡性鑒別診斷的價(jià)值。方法:選取我院眼科2011-2013年62例眼眶占位患者均行超聲造影和MRI增強(qiáng)檢查并分別做出診斷。以病理診斷為標(biāo)準(zhǔn),計(jì)算兩種檢查方法在眼眶腫瘤中的診斷符合率、敏感性及特異率;然后依照病理結(jié)果將62例患者分為良惡性兩組,比較兩種檢查方法增強(qiáng)強(qiáng)度在眼眶腫瘤良惡性組別中表達(dá)的差異性,分析增強(qiáng)模式的不同對良惡性鑒別的價(jià)值;應(yīng)用Sonoliver軟件分析所有62例眼科超聲造影的病例,處理得到腫瘤造影時(shí)間-強(qiáng)度曲線(TIC),獲取造影劑達(dá)到時(shí)間(AT)、上升時(shí)間(RT)、達(dá)峰時(shí)間(TTP)、平均渡越時(shí)間(mTT)、半洗出時(shí)間進(jìn)行定量分析;應(yīng)用卡方檢驗(yàn)及非參檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1在對62列眼眶腫瘤的患者診斷中,CEUS與增強(qiáng)MRI的診斷符合率無差異,分別為82.3%和80.6%;敏感性分別為64.7%與70.2%,特異度分別為88.9%與84.4%,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2在增強(qiáng)強(qiáng)度的比較中,CEUS增強(qiáng)強(qiáng)度在良惡性組別中分布存在不同(P0.05);MRI增強(qiáng)強(qiáng)度在良惡性組別中分布無明顯差異。3根據(jù)TIC獲取的參數(shù)中:AT、RT、TTP、半洗出時(shí)間等參數(shù)在良惡性腫瘤分組中存在差異(P0.05);而mTT在兩者之間無明顯差異。結(jié)論:超聲造影在眼眶腫瘤的診斷符合率與MRI的表現(xiàn)無明顯差異,而敏感性低于增強(qiáng)MRI,特異度高于增強(qiáng)MRI;超聲造影的增強(qiáng)強(qiáng)度及造影時(shí)間-強(qiáng)度曲線在良惡性分組中存在明顯差異,有利于進(jìn)一步鑒別眼眶腫瘤的良惡性。在無法行增強(qiáng)MRI檢查的病例中,超聲造影作為一種補(bǔ)充檢查方法有一定的臨床價(jià)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.
【作者單位】： 武漢大學(xué)人民醫(yī)院超聲影像科;湖北省黃岡市中心醫(yī)院超聲影像科;武漢大學(xué)人民醫(yī)院眼科;
【分類號】：R739.7;R445.2

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