视网膜母细胞瘤MSCT MRI表现及其诊断价值分析

Diagnostic Value and Imaging Features of Retinoblastoma(Rb)on MSCT and MRI

目的:对比多层螺旋电子计算机断层扫描(MSCT)、磁共振成像(MRI)检测方法在视网膜母细胞瘤(Rb)检测中的诊断价值。方法:选择2019年1月到2023年6月期间于我院治疗的125例疑似Rb患者,采用MSCT、MRI进行检测,通过病理检测结果为诊断金标准,分析不同检测方法对Rb检测的灵敏度、特异度、准确性,以及与病理检测结果的一致性。结果:患者经MRI、MSCT、病理检测的Rb阳性率分别为44.00%(55/125)、52.80%(66/125)、45.60%(57/125),差异无统计学意义(P>0.05);MRI检测结果与病理检测结果比对的Kappa值为0.644,低于MSCT检测的Kappa值0.729;MRI检测的灵敏度为78.94%,低于MSCT检测的灵敏度92.98%,差异有统计学意义(P<0.05);MRI检测的特异度(85.29%)高于MSCT检测(80.88%),准确率(82.40%)低于MSCT检测(86.40%),差异无统计学意义(P>0.05);MSCT视野下Rb患者眼球壁有不规则增厚,玻璃体腔内见不规则片状软组织密度影,病灶内见斑片状钙化;MRI视野下Rb患者眼环不均匀增厚,玻璃体腔内可见不规则团片状异常信号影,T1WI呈等信号,T2WI呈稍高、低混杂信号影,增强扫描见病灶明显不均匀强化。结论:与MRI检测相比,MSCT检测与病理检测结果的一致性高,并具有更高的灵敏度,具有较高的诊断价值。

Objective:To compare the diagnostic value of MSCT and MRI in the detection of retinoblastoma(Rb).Methods:A total of 125 suspected Rb patients treated at our hospital from January 2019 to June 2023 were included.MSCT and MRI were performed,with pathological findings used as the gold standard for diagnosis.Sensitivity,specificity,accuracy,and consistency with pathological results were analyzed for both imaging modalities.Results:The positivity rates of Rb detected by MRI,MSCT,and pathology were 44.00%(55/125),52.80%(66/125),and 45.60%(57/125),respectively,with no statistically significant difference(P>0.05).The Kappa value for MRI compared to pathology was 0.644,lower than the Kappa value of 0.729 for MSCT.The sensitivity of MRI(78.94%)was lower than that of MSCT(92.98%),with a statistically significant difference(P<0.05).The specificity of MRI(85.29%)was higher than that of MSCT(80.88%),while the accuracy of MRI(82.40%)was lower than that of MSCT(86.40%),but these differences were not statistically significant(P>0.05).MSCT showed irregular thickening of the eyeball wall,irregular nodular soft tissue density in the vitreous cavity,and patchy calcifications within the lesion.MRI revealed uneven thickening of the eyeball ring,irregular mass-like abnormal signal shadows in the vitreous cavity,isointense signal on T1-weighted imaging(T1WI),slightly hyper-to hypo-intense mixed signal on T2-weighted imaging(T2WI),and heterogeneous enhancement on contrast-enhanced scans.Conclusion:Compared to MRI,MSCT demonstrates higher consistency with pathological findings and higher sensitivity in detecting Rb,indicating superior diagnostic value.