超声对小儿神经母细胞瘤的诊断价值分析

Diagnostic value of ultrasonography in pediatric neuroblastoma

目的分析彩色多普勒超声在小儿神经母细胞瘤中的诊断价值。方法选取2018年1月至2020年1月本院收治的神经母细胞瘤患儿20例,术前均接受超声和CT检查,分析神经母细胞瘤的超声与CT表现及与术后病理诊断的符合率。结果小儿神经母细胞瘤的超声表现主要为结节状和不规则的融合状等,超声内部回声显示多为不均匀低实质性回声,血流分级以Ⅱ~Ⅲ级为主,肿瘤部位以肾上腺为主。以术后病理诊断为金标准,神经母细胞瘤超声诊断的准确率为90.0%(18/20),CT诊断的准确率为60.0%(12/20),超声诊断的准确率高于CT诊断(χ^(2)=4.800,P<0.05)。超声诊断与病理诊断的一致性较高(Kappa=0.783,P<0.05),CT诊断与病理诊断的一致性相对较低(Kappa=0.266,P=0.097)。结论彩色多普勒超声可有效实现对患儿神经母细胞瘤不同病理类型的诊断,具有较好的诊断价值。

Objective To determine the diagnostic value of color Doppler ultrasonography in pediatric neuroblastoma.Methods Twenty children with neuroblastoma admitted to our hospital between January 2018 and January 2020 were included in the study and received ultrasonography and CT examination before the surgery.The coincidence rate between ultrasound and CT findings of neuroblastoma and postoperative pathological diagnosis were determined.Results The ultrasound findings of the children with neuroblastoma were mainly nodular and irregular fusions.The internal echo showed mostly uneven low-substantial echo.The blood flow classification was mainly grade Ⅱ-Ⅲ,and the tumor site was mainly adrenal gland.Taking postoperative pathological diagnosis as the gold standard,the diagnostic accuracy of ultrasonography and CT for neuroblastoma was 90.0%(18/20)and 60.0%(12/20),respectively.The diagnostic accuracy of ultrasonography was higher than that of CT(χ^(2)=4.800,P<0.05).The consistency between ultrasound diagnosis and pathological diagnosis was relatively high(Kappa=0.783,P<0.05),and the consistency between CT diagnosis and pathological diagnosis was relatively low(Kappa=0.266,P=0.097).Conclusion Color Doppler ultrasonography may effectively diagnose different pathological types of neuroblastoma in children,with good diagnostic value.