摘要
目的:探讨CT胸腺厚度联合视觉评分对非胸腺瘤型重症肌无力(MG)胸腺异常的诊断价值。方法:收集2018年3月至2020年9月就诊于河南省人民医院重症肌无力综合诊疗中心的非胸腺瘤型MG患者51例及该院52例体检健康者的CT影像学及一般资料。以术后病理为胸腺异常的MG患者为胸腺异常组,体检健康者为胸腺正常组,对其CT图像进行胸腺厚度测量和胸腺视觉评分。以胸腺异常为因变量(Y),以胸腺厚度(X_(1))、年龄(X_(2))为自变量构建Logistic回归方程1,以胸腺厚度(X_(1))、年龄(X_(2))及视觉评分(X_(3))为自变量构建Logistic回归方程2。纳入全部103人为诊断对象,绘制两个回归方程诊断胸腺异常的ROC曲线。结果:51例MG患者中,病理显示胸腺增生40例(78.44%),微小胸腺瘤4例(7.84%),萎缩4例(7.84%),正常3例(5.88%)。胸腺异常组(48例)与正常组胸腺厚度及视觉评分均随年龄的增长变化较大。回归方程1为Y=-3.831+0.253X_(1)+0.012X_(2)。回归方程2为Y=-16.443+0.376X_(1)+0.107X_(2)+5.604X_(3)。绘制回归方程1和回归方程2诊断胸腺异常的ROC曲线,其AUC(95%CI)分别为0.866(0.783~0.926)、0.963(0.905~0.991),回归方程2的AUC大于回归方程1(P=0.020)。结论:CT胸腺厚度联合视觉评分对非胸腺瘤型MG胸腺异常有较高的诊断价值。
Aim:To explore the value of CT thymus thickness combined with visual score in the diagnosis of thymic abnormalities of non-thymoma myasthenia gravis(MG).Methods:A total of 51 non-thymoma MG patients from March 2018 to September 2020 at the Comprehensive Diagnosis and Treatment Center for Myasthenia Gravis of Henan Provincial People′s Hospital,and 52 healthy controls were enrolled.Their CT images and clinical data were collected.The MG patients with abnormal thymus according the postoperative pathological results were abnormal thymus group,and the healthy controls were regarded as the normal thymus group.The thickness and visual score of thymus were measured based on CT images.Logistic regression model 1 was constructed with thymus abnormality as dependent variable(Y),thymus thickness(X_(1))and age(X_(2))as independent variables;Logistic regression model 2 was constructed with thymus thickness(X_(1)),age(X_(2))and visual score(X_(3))as independent variables.All 103 subjects were included to draw the ROC curves of the two models in diagnosing thymus abnormalities.Results:The pathological results of 51 MG patients showed 40(78.44%)thymic hyperplasia,4(7.84%)microthymoma,4(7.84%)atrophy,and 3(5.88%)normal.The thymus thickness and visual score of the abnormal thymus group(48 cases)and the normal thymus group changed significantly with age.Model 1,Y=-3.831+0.253X_(1)+0.012X_(2).Model 2,Y=-16.443+0.376X_(1)+0.107X_(2)+5.604X_(3).The AUC(95%CI)of the ROC curves of model 1 and model 2 in diagnosing thymus abnormalities were 0.866(0.783-0.926)and 0.963(0.905-0.991),respectively,and the AUC of model 2 was better than that of model 1(P=0.020).Conclusion:CT thymic thickness combined with visual score has high diagnostic value for non-thymoma MG thymic abnormalities.
作者
崔新征
赵卫浩
赵婧革
马文强
李永丽
张清勇
史宸硕
CUI Xinzheng;ZHAO Weihao;ZHAO Jingge;MA Wenqiang;LI Yongli;ZHANG Qingyong;SHI Chenshuo(Comprehensive Diagnosis and Treatment Center for Myasthenia Gravis,Henan Provincial People′s Hospital,Zhengzhou 450003)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2021年第6期746-749,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省科技厅科技攻关项目(162102310505,212102310153)。
