摘要
目的探讨磁共振扩散加权成像(DWI)在预测直肠癌新辅助放化疗后病理完全缓解(pCR)的应用价值。方法回顾性分析2015年1月—2018年12月在医院接受新辅助放化疗的80例直肠癌患者的临床资料,新辅助放化疗前均行常规磁共振成像(MRI)和DWI,观察两种检查方式对直肠癌新辅助放化疗后pCR的诊断效率,并分析DWI对直肠癌新辅助放化疗后pCR的预测价值。结果常规MRI预测直肠癌新辅助放化疗后pCR的准确率为70.00%,灵敏度为36.36%,特异度为82.76%,阳性预测值为44.44%,阴性预测值为77.42%,Kappa值为0.203;DWI预测直肠癌新辅助放化疗后pCR的准确率为88.75%,灵敏度为68.18%,特异度为96.55%,阳性预测值为88.24%,阴性预测值为88.89%,Kappa值为0.696。常规MRI和DWI对直肠癌新辅助放化疗后pCR均具有一定的预测价值,曲线下面积分别为0.782、0.843。结论相比于常规MRI,DWI预测直肠癌新辅助放化疗后pCR的准确率较高,具有较高的临床应用价值。
Objective To study the clinical manifestations,pathological features,diagnosis,differential diagnosis,treatment and prognosis of axillary glomus tumor. Methods A retrospective analysis was made on the clinical data and pathological results of a patient with chronic shoulder and back pains diagnosed by pathology as axillary glomus tumor in a hospital in January 2019. Results A 72 year-old male patient was admitted to the hospital because of left shoulder and back pain for8 years. After hospitalization,left axillary neuropathic pain was treated with left C6 spinal nerve block. The pains were alleviated slightly,but there was still axillary tenderness. Then,myoskeletal ultrasonography revealed glomus tumors which were surgically resected and pathologically diagnosed as glomus tumors. Conclusion Shoulder and back pains caused by axillary glomus tumor are rare. It is difficult to diagnose it for lacking of typical symptoms and signs. A better understanding of glomus tumors in non-predisposing sites,careful physical examination and early ultrasound examination can effectively avoid misdiagnosis and missed diagnosis. Complete resection of tumors can achieve definite curative effect,and close follow-up is needed after operation.
出处
《现代医院》
2020年第5期775-778,共4页
Modern Hospitals
基金
广东省医药卫生科技计划项目(A2017652)
梅州市科技计划科技项目(2018B031)
