CT联合MRI在视网膜母细胞瘤诊断中的应用价值

Diagnostic value of CT combined with MRI for retinoblastoma

目的探讨电子计算机断层扫描(CT)、磁共振成像(MRI)联合在视网膜母细胞瘤(RB)诊断中的应用价值。方法回顾性抽取2022年2月至2024年1月西安市人民医院收治的96例疑似RB患儿,均行CT、MRI检查,以手术或病理活检结果为"金标准",分析CT、MRI单独及联合的诊断效能,进一步分析CT、MRI单独及联合诊断与手术或病理活检结果的一致性。结果CT、MRI单独诊断的灵敏度(71.05%,27/38;65.79%,25/38)、阴性预测值(81.36%,48/59;77.97%,46/59)低于联合诊断(94.74%,36/38;95.83%,46/48),CT、MRI单独诊断的漏诊率(28.95%,11/38;34.21%,13/38)高于联合诊断(5.26%,2/38),P均<0.05。CT、MRI单独及联合诊断肿瘤分期的效果与手术或病理活检获得的分期结果的一致性Kappa值均高于0.40,但CT与MRI联合诊断分期的Kappa值(0.94)高于单独诊断(P<0.05)。结论CT联合MRI诊断RB可提高诊断灵敏度,降低漏诊率,且CT与MRI联合诊断与手术或病理活检结果具有较好的一致性,可为临床诊断提供有效参考依据。

Objective To investigate the diagnostic value of computed tomography(CT)combined with magnetic resonance imaging(MRI)for retinoblastoma(RB).Methods Ninety-six children with suspected RB admitted to Xi’an People’s Hospital from February 2022 to January 2024 was retrospectively selected,and all of them underwent CT and MRI examinations.The diagnostic performance of CT alone,MRI alone and combination of them were analyzed with the results of surgery or pathological biopsy as the gold standard.The consistencies of the diagnostic results of CT alone,MRI alone and combination of them with the results of surgery or pathological biopsy were further analyzed.Results The sensitivity and negative predictive value of CT alone(71.05%,27/38;81.36%,48/59)and MRI alone(65.79%,25/38;77.97%,46/59)were lower than those of combined diagnosis(94.74%,36/38;95.83%,46/48),P<0.05;the missed diagnosis rate of CT alone(28.95%,11/38)and MRI alone(34.21%,13/38)were higher than that of combined diagnosis(5.26%,2/38),all P<0.05.CT alone,MRI alone,and combined diagnosis had general consistencies with surgery or pathological biopsy in staging of tumors(all Kappa>0.04),and the Kappa value of combined diagnosis of CT and MRI was 0.94,higher than those of the two single methods(P<0.05).Conclusions CT combined with MRI can improve the sensitivity,reduce the missed diagnosis rate in the diagnosis of RB.And the combined diagnosis has a good consistency with the results of surgical or pathological biopsy,therefore,it can provide a powerful reference for clinical diagnosis.