摘要
目的探讨MRI对软腭占位性病变定性诊断的应用价值。方法回顾性分析经病理证实的26例软腭占位性病变的MRI影像学征象,将影像诊断与病理结果采用配对计数资料的2检验和Kappa检验进行分析,并计算其敏感性、特异度、准确度及约登指数。结果 26例软腭占位病理诊断中,良性15例,以血管瘤及多形性腺瘤多见,恶性11例,以鳞癌多见。良性占位性病变MRI典型表现为肿块边界清晰,信号较均匀,坏死少见,偶见钙化,增强扫描常较均匀强化,囊肿无强化;恶性占位性病变MRI典型表现为肿块境界不清,外形不规则或呈分叶状,信号不均匀,中心易坏死,常伴有周围淋巴结肿大,增强后常不均匀强化,坏死区无强化。MRI诊断与病理诊断吻合度较高(2=0.766,P<0.05),术前影像诊断软腭良恶性占位性病变的灵敏度、特异度、准确度及约登指数分别为90.9%、86.7%、88.5%、77.6%。结论术前MRI检查对软腭占位性病变定性诊断及鉴别诊断具有重要的价值。
Objective To evaluate the diagnostic value of CT and MRI in soft palate occupying lesions. Methods We retrospectively analyzed the CT and MRI imaging manifestations in 26 cases of the soft palate occupying lesions proved pathology. The image diagnosis and pathology results were matched for Pair-Sample X^2Test and Kappa Test. The sensitivity,specificity,accuracy and Youden index were calculated. Results According to pathological results,the 26 patients were divided into two groups,benignant lesion（ 15 patients）,and malignant lesion（ 11 patients）. Hemangioma and pleomorphic adenoma were easier to appear in the benign group. Squamous cell carcinoma was easier to be found in the malignant group. The typical imaging manifestations were clear boundary,uniform density and signal,rare necrosis,occasional calcification,relatively homogeneous enhancement,and cyst without reinforcement in the soft palate occupying lesions. On the contrary,representative imaging findings were obscure boundary,irregular shape or lobulated,central necrosis,accompanied by lymphadenectasis,uneven enhancement,necrosis without reinforcement in the malignant lesions. The coincidence degree between imaging diagnosis and pathologic analysis was higher（k = 0. 766,P〈0. 05）. The sensitivity,specificity,accuracy and Youden＇ s index in the preoperative diagnosis of soft palate benign or malignant occupying lesions were 90. 9%,86. 7%,88. 5%,77. 6%,respectively. Conclusion Preoperative MRI examination has very important value in the qualitative diagnosis and differential diagnosis of soft palate occupying lesions.
出处
《医学影像学杂志》
2016年第4期601-605,共5页
Journal of Medical Imaging
关键词
软腭
肿瘤
磁共振成像
诊断鉴别
Soft palate
Neoplasm
Magnetic resonance imaging
Diagnosis differential
