超声与MRI对四肢腱鞘巨细胞瘤的诊断一致性比较

Comparative Study on the Diagnostic Consistency of Ultrasound and MRI in Giant Cell Tumor of Tendon Sheath in Extremities

目的探讨超声与MRI对四肢腱鞘巨细胞瘤诊断的一致性及临床价值。资料与方法回顾性分析2020年1月—2022年12月因手足部肿物于赣南医学院第一附属医院就诊,同时接受超声和MRI检查并经手术或者穿刺细胞学检查确诊的35例患者。以病理结果作为“金标准”,比较两种检查方法敏感度、特异度和阳性似然比,分析诊断分类的一致性和临床价值。结果35例手足部肿物中,超声诊断腱鞘巨细胞瘤17例,MRI诊断16例,病理诊断15例。超声和MRI对手足部肿物的诊断分类一致30例,分类不一致5例,两者一致性较强(Kappa=0.714)。超声诊断四肢腱鞘巨细胞瘤的敏感度、特异度、符合率分别为73.3.%、70.0%、71.4%,MRI诊断的敏感度、特异度、符合率分别为80.0%、80.0%、80.0%,两者联合诊断的敏感度、特异度、符合率分别为86.7%、70.0%、77.1%。超声、MRI、两者联合诊断与病理检查诊断准确度比较差异均无统计学意义(P>0.05)。超声、MRI及两者联合诊断手足部肿物的敏感度、特异度、阳性似然比差异均无统计学意义(P>0.05)。结论超声与MRI在四肢腱鞘巨细胞瘤的分类诊断中具有较好的一致性,两者在四肢腱鞘巨细胞瘤诊断效能上差异无统计学意义。

Purpose To explore the consistency and clinical value of ultrasound and MRI in the diagnosis of giant cell tumor of tendon sheath(GCTTS)in extremities.Materials and Methods A retrospective analysis was performed on 35 patients who came to the First Affiliatted Hospital of Gannan Medical University from January 2020 to December 2022 due to hand-foot masses,and underwent ultrasound and MRI examination,which were confirmed by surgery or puncture cytology.Taking pathological results as the“gold standard”,the sensitivity,specificity and positive likelihood ratio were compared,and the consistency and clinical value of the diagnostic classification of the two examination methods were further analyzed.Results Among the 35 cases of hand-foot masses,17 cases were diagnosed of GCTTS by ultrasound,16 cases were diagnosed of GCTTS by MRI,and 15 cases were diagnosed of GCTTS by pathologically.Ultrasound and MRI were consistent in the diagnostic classification of hand-foot masses in 30 cases and were inconsistent in diagnostic classification in 5 cases,and the diagnostic classification of the two mehtods was strongly consistent(Kappa=0.714).The sensitivity,specificity and coincidence rates of GCTTS in extremities diagnosed by ultrasound were 73.3%,70.0% and 71.4%,respectively.Those of GCTTS in extremities diagnosed by MRI were 80.0%,80.0% and 80.0%,respectively.Those of GCTTS in extremities diagnosed by ultrasound combined with MRI were 86.7%,70.0% and 77.1%,respectively.There were no significant differences in the diagnostic accuracy among ultrasound,MRI,ultrasound and MRI combined diagnosis and pathological examination(P>0.05).There were no significant differences in sensitivity,specificity,and positive likelihood ratio among ultrasound,MRI and the combined diagnosis of hand-and foot masses(P>0.05).Conclusion Ultrasound and MRI have good consistency in the classification and diagnosis of GCTTS in extremities.There was no significant difference between ultrasound and MRI in the overall diagnostic performance of GCTTS in extremities.