术中超声、术中超声造影与MRI对不同级别胶质瘤的诊断一致性分析

Evaluation of the consistency among intraoperative ultrasound, contrast enhanced ultrasound and MRI in determining the diagnosis of different grade gliomas

目的通过术中超声、术中超声造影与MRI对诊断不同级别胶质瘤的一致性进行分析。方法对术前经MRI、术中超声及术中超声造影诊断并被病理证实为胶质瘤的42例患者进行分析,探讨三种检查方法与病理结果在诊断不同级别胶质瘤的一致性,以及三种检查方法之间在诊断不同级别胶质瘤的一致性。结果二维超声与病理结果的一致性差(Kappa=0.381,P=0.013),超声造影与病理结果的一致性好(Kappa=0.667,P=0.000),MRI与病理结果的一致性中等(Kappa=0.583,P=0.000),二维超声与超声造影的一致性中等(Kappa=0.476,P=0.001)。MRI与超声造影的一致性中等(Kappa=0.521,P=0.000)。结论超声造影与二维超声、MRI相比在诊断不同级别胶质瘤中有优势,能为胶质瘤的诊断及初步分级提供参考依据。

Objective To evaluate the consistency of intraoperative ultrasound, contrast enhanced ultrasound and MRI in diagnosis of different grade of glioma. Methods 42 patients with glioma were diagnosed by the preoperative MRI, intraoperative ultrasound and contrast enhanced ultrasound, while confirmed by pathology, the consistency of different grade gliomas diagnosed by intraoperative ultrasound,contrast enhanced ultrasound and MRI between pathological results were explored. As well as the consistency in diagnosis of different grade gliomas among the contrast enhanced ultrasound, the preoperative MRI and intraoperative ultrasound. Results US and pathological results exhibited low consistency （K=0.381, P=0.013）, CEUS and pathological results exhibited high consistency （Kappa=0.667, P=0.000）, MRI and pathological results exhibited medium consistency （Kappa=0.583, P=0.000）, US and CEUS exhibited medium consistency （Kappa=0.476, P=0.001）, MRI and CEUS exhibited medium consistency （Kappa=0.521, P=0.000）. Conclusion CEUS have advantages in the different level in the diagnosis of glioma compared with MRI and US, and it can offer reference basis for the diagnosis of glioma and preliminary classification.