探讨CT联合MRI对小儿胰母细胞瘤与腹膜后神经母细胞瘤的鉴别诊断价值分析

The Value of CT Combined with MRI in the Differential Diagnosis of Pancreatic Blastoma and Retroperitoneal Neuroblastoma in Children

目的探讨CT联合MRI对小儿胰母细胞瘤与腹膜后神经母细胞瘤的鉴别诊断价值。方法回顾性分析2010年2月至2021年5月本院收治的经病理检查诊断为胰母细胞瘤或腹膜后神经母细胞瘤的56例患儿的病历资料,患儿病理检查前均实施CT和MRI检查。以患儿病理结果为“金标准”,应用受试者工作特征曲线分析CT联合MRI对小儿胰母细胞瘤与腹膜后神经母细胞瘤的鉴别诊断价值。结果CT鉴别小儿胰母细胞瘤与腹膜后神经母细胞瘤的灵敏度、特异度、准确度、曲线下面积(AUC)分别为86.67%、90.24%、89.29%、0.885;MRI鉴别小儿胰母细胞瘤与腹膜后神经母细胞瘤的灵敏度、特异度、准确度、AUC分别为80.00%、92.68%、89.29%、0.863;CT联合MRI鉴别小儿胰母细胞瘤与腹膜后神经母细胞瘤的灵敏度、特异度、准确度、AUC分别为100.00%、90.24%、92.86%、0.951。CT联合MRI鉴别诊断的灵敏度、准确度略高于单一检查诊断,特异度与单一检查诊断相近,差异均无统计学意义(P>0.05),联合诊断的AUC均高于单一检查诊断。结论CT、MRI均对小儿胰母细胞瘤与腹膜后神经母细胞瘤具有一定的鉴别诊断价值,但二者联合的鉴别诊断价值更高。

Objective To explore the value of CT combined with MRI in the differential diagnosis of pancreatic blastoma and retroperitoneal neuroblastoma in children.Methods:The medical records of 56 children with pancreatoblastoma or retroperitoneal neuroblastoma diagnosed by pathological examination in our hospital from February 2010 to may 2021 were analyzed retrospectively,and CT and MRI were performed before pathological examination.With the pathological results of children as the"gold standard",the value of CT combined with MRI in the differential diagnosis of children’s pancreatoblastoma and retroperitoneal neuroblastoma was analysed by receiver operating characteristic curves.Results:The sensitivity,specificity,accuracy and area under curve(AU C)of CT in differentiating children's pancreatoblastoma and retroperitoneal neuroblastoma were 86.67%,90.24%,89.29%and 0.885 respectively.The sensitivity,specificity,accuracy and AU C of MRI in differentiating children's pancreatoblastoma and retroperitoneal neuroblastoma were 80.00%,92.68%,89.29%and 0.863 respectively.The sensitivity,specificity,accuracy and AUC of CT combined with MRI were 100.00%,90.24%,92.86%and 0.951 respectively.The sensitivity and accuracy of CT combined with MRI in differential diagnosis were slightly higher than that of single examination,while the specificity was similar to that of single examination,and the difference was not statistically significant(P>0.05).The AU C of combined diagnosis was higher than that of single examination.Conclusion:CT and MRI have certain differential diagnostic value in children with pancreatoblastoma and retroperitoneal neuroblastoma,but the differential diagnostic value of the combination is higher.