核磁共振成像诊断儿童髓母细胞瘤的准确性及影像学特征分析

Analysis of the accuracy and imaging features of MRI in the diagnosis of medulloblastoma in children

目的分析核磁共振成像(MRI)诊断儿童髓母细胞瘤的准确性及影像学特征。方法回顾性分析天津市环湖医院2018年1月—2021年3月期间收取的43例疑似为髓母细胞瘤患儿的临床资料,具有完整的CT、MRI检查资料,以手术病理学诊断作为金标准,统计两种技术的诊断价值,分析其影像学特征。结果MRI检测髓母细胞瘤检出率(93.33%)高于CT检出率(60.0%),差异有统计学意义(P<0.05),MRI诊断的灵敏度、特异度、准确性、阳性预测值及阴性预测值分别为92.86%、73.33%、86.05%、86.67%、73.33%,均高于CT的77.78%、36.0%、53.49%、46.67%、36.0%(P<0.05)。髓母细胞瘤肿瘤病灶形态规则、无钙化、实性成分内小囊变或无囊变、肿瘤病灶内无出血、无水肿、实性部分DWI高信号、均匀强化占比率均高于间变室管膜瘤(P<0.05)。结论MRI诊断儿童髓母细胞瘤的准确性高,能提供肿瘤定位、定性、部位、形态、囊性改变等具体影像学特征,临床价值明显。

Objective Analyze the accuracy and imaging characteristics of MRI in the diagnosis of medulloblastoma in children.Methods To retrospectively analyze the clinical data of 43 children with suspected medulloblastoma collected in our hospital from January 2018 to March 2021,with complete CT and MRI examination data,with surgical pathological diagnosis as the gold standard,and statistics Analysis of the diagnostic value of the two technologies and their imaging features.Results The medulloblastoma detected by MRI accounted for 93.33%,which was higher than the detection rate of CT by 60.0%(P<0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI were 92.86%,73.33%,86.05%,86.67%,73.33%,all higher than the 77.78%,36.0%,53.49%,46.67%,36.0%of CT(P<0.05).Medulloblastoma tumor lesions have regular morphology,no calcification,small cysts or no cysts in solid components,no bleeding,no edema in the tumor lesions,solid parts of DWI high signal,and the proportion of uniform enhancement is higher than that of the anaplastic chamber Ependymoma(P<0.05).Conclusion MRI is highly accurate in diagnosing medulloblastoma in children.It can provide specific imaging features such as tumor location,characterization,location,morphology,and cystic changes,and has obvious clinical value.