摘要
目的 :探讨MRI冠状位丘脑中间块高度显著增大及占位征象对双侧中线旁丘脑肿瘤的诊断价值。方法 :回顾性分析某院2012年1月至2023年1月行头部MRI检查的具有双侧中线旁丘脑病变的72例肿瘤患者的病历资料,其中23例肿瘤患者作为肿瘤组,49例非肿瘤患者作为非肿瘤组。由2名观察者独立评估入组病例的病灶是否具有占位效应,并测量MRI冠状位丘脑中间块高度,取所有患者的丘脑中间块高度的平均值作为标准,大于平均值者判定为丘脑中间块显著增大。比较2组间丘脑中间块高度增大程度及病灶占位效应,并计算丘脑中间块显著增大及占位效应诊断双侧中线旁丘脑肿瘤的敏感度、特异度、阴性预测值及阳性预测值。采用SPSS 26.0软件进行统计学分析。结果:入组患者丘脑中间块平均高度为9.3 mm。2名观察者对丘脑中间块高度是否显著增大(丘脑中间块高度>9.3 mm)及是否具有占位效应的判定结果一致性较好(K_(中间块)=0.862,K_(占位效应)=0.830)。肿瘤组患者丘脑中间块高度显著增大、具有占位效应者均多于非肿瘤组(χ~2=46.813,P<0.001;χ~2=39.600,P<0.001)。丘脑中间块高度显著增大(丘脑中间块高度>9.3 mm)诊断双侧中线旁丘脑肿瘤的敏感度、特异度分别为78.3%和98.0%,阴性预测值、阳性预测值分别为90.6%和94.7%。占位效应诊断双侧中线旁丘脑肿瘤的敏感度、特异度分别为73.9%和95.9%,阴性预测值、阳性预测值分别为88.7%和89.5%。结论:丘脑中间块高度显著增大(丘脑中间块高度>9.3 mm)对诊断双侧中线旁丘脑肿瘤具有一定的价值,诊断效能优于占位效应。MRI冠状位对双侧中线旁丘脑病变具有辅助诊断意义。
Objective To investigate the diagnostic value of the thalamus massa intermedia with significantly increased height and space-occupying signs for bilateral paramedian thalamic tumors.Methods The medical records of 72 patients with paramedial bithalamic lesions who underwent head MRI from January 2012 to January 2023 at some hospital were analyzed retrospectively,including 23 tumor patients enrolled into a tumor group and 49 non-tumor patients divided into a non-tumor group.Two observers independently assessed whether the lesions in the enrolled cases had a space-occupying effect and measured the height of the thalamus massa intermedia in MRI coronal images.The patients were considered to have significantly enlarged thalamus massa intermedia in case the heights of the thalamus massa intermedia were higher than the mean value.The two groups were compared in terms of the height of the thalamus massa intermedia and space-occupying effect,and the sensitivity,specialty,negative predictive value and positive predictive value were calculated when the height of the thalamus massa intermedia and space-occupying effect were used for diagnosing bilateral paramedian thalamic tumors.Statistical analysis was carried out with SPSS 26.0 software.Results The enrolled patients had a mean height of the thalamus massa intermedia of 9.3 mm.There was high agreement between the 2 observers in determining whether the thalamus massa intermedia height was significantly increased(thalamus massa intermedia height>9.3 mm)and whether space-occupying effect existed(Kmassa intermedia=0.862,Kspace-occupying effect=0.830).There were more patients in the tumor group with significantly increased thalamus massa intermedia height and space-occupying effect than those in the non-tumor group(χ2=46.813,P<0.001;χ2=39.600,P<0.001).The sensitivity,specialty,negative predictive value and positive predictive value were 78.3%,98.0%,90.6%and 94.7%respectively for the height of the thalamus massa intermedia used to diagnose bilateral paramedian thalamic tumors,
作者
苏录
周剑
薛静
高培毅
SU Lu;ZHOU Jian;XUE Jing;GAO Pei-yi(Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Neuroradiology Center of Beijing Neurosurgical Institute,Beijing 100070,China)
出处
《医疗卫生装备》
CAS
2023年第6期52-56,共5页
Chinese Medical Equipment Journal
关键词
双侧中线旁丘脑
丘脑中间块高度
丘脑肿瘤
占位效应
bilateral paramedian thalamus
height of thalamus massa intermedia
thalamic tumor
space-occupying effect
