论著

磁共振成像CUBE序列在眼眶肿瘤及肿瘤样病变中的诊断价值

The diagnostic value of magnetic resonance imaging CUBE sequence for orbital tumors and tumor like lesions

:453-458
 
      目的 探究磁共振成像三维快速自旋回波序列(CUBE)序列在眼眶肿瘤及肿瘤样病变中的诊断价值。方法 选取2023年5月—2025年6月郑州市第二人民医院收治的眼眶肿瘤及肿瘤样病变患者89例为研究对象,依据病理诊断结果分为眼眶肿瘤组(43例)及肿瘤样病变组(46例)。分别采用病理检查及磁共振成像CUBE序列对研究对象进行检测。比较眼眶肿瘤组与肿瘤样病变组的资料。采用Kappa检验比较病理金标准与磁共振成像CUBE序列鉴别诊断的一致性。采用2×2列联表分析磁共振成像CUBE鉴别眼眶肿瘤及肿瘤样病变的诊断效能。结果 病理鉴别诊断结果与磁共振成像CUBE序列结果比较,差异无统计学意义(P>0.05)。眼眶肿瘤组与肿瘤样病变组的资料比较,差异无统计学意义(P>0.05)。Kappa检验发现,磁共振成像CUBE序列鉴别眼眶肿瘤与肿瘤样病变与病理金标准比较的Kappa值为0.820,一致性较高(P<0.05)。磁共振成像CUBE序列鉴别眼眶肿瘤及肿瘤样病变的灵敏度为88.37%,特异度为93.48%,准确度为91.01%,误诊率为6.52%,漏诊率为11.63%,约登指数为81.85%,阳性预测概率为92.68%,阴性预测概率为89.58%。结论 磁共振成像CUBE序列鉴别诊断成人眼眶肿瘤及肿瘤样病变与病理诊断结果的一致性较高。
     Objective To investigate the diagnostic value of the three-dimensional fast spin echo sequence(CUBE)in magnetic resonance imaging for orbital tumors and tumor-like lesions.Methods From May 2023 to June 2025,89 patients with orbital tumors and tumor like lesions were included as the study subjects.Based on pathological diagnosis results,they were separated into orbital tumor group(43 cases)and tumor like lesion group(46 cases).The pathological examination and magnetic resonance imaging CUBE sequence were used to scan the study subjects.The data were compared between the orbital tumor group and the tumor like lesion group.Kappa test was used to compare the consistency of differential diagnosis between pathological gold standard and magnetic resonance imaging CUBE sequence.A 2×2 contingency table was uesd to analyze the diagnostic performance of magnetic resonance imaging CUBE in differentiating orbital tumors and tumor-like lesions.Results The difference between the pathological differential diagnosis results and the magnetic resonance imaging CUBE sequence was not statistically significant(P>0.05).The data comparison between the orbital tumor group and the tumor like lesion group showed no statistical difference(P>0.05).The Kappa test found that the Kappa value of 0.820 for differentiating orbital tumors from tumor like lesions using the magnetic resonance imaging CUBE sequence compared to the pathological gold standard was highly consistent(P<0.05).The sensitivity,specificity,accuracy,misdiagnosis rate,missed diagnosis rate,Youden index,positive predictive probability,and negative predictive probability of magnetic resonance imaging CUBE sequence in differentiating orbital tumors and tumor like lesions were 88.37%,93.48%,91.01%,6.52%,11.63%,81.85%,92.68% and 89.58%,respectively.Conclusions The magnetic resonance imaging CUBE sequence has a high consistency with pathological diagnosis results in the differential diagnosis of orbital tumors and tumor like lesions.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative diagnostic value of 99mTc-MIBI SPECT/CT dual-phase imaging and ultrasound in preoperative localization of secondary hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

:-
 
目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.
论著

临床特征联合外周血血管内皮生长因子和 α- 羟基丁酸脱氢酶对卵巢癌的诊断价值

Diagnostic value of clinical features combined with peripheral blood vascular endothelial growth factor and α-hydroxybutyrate dehydrogenase levels in ovarian cancer

:77-82
 
        目的   探讨临床特征联合外周血血管内皮生长因子(VEGF)与α-羟基丁酸脱氢酶(α-HBDH)对卵巢癌的诊断价值。方法   选取2022年6月—2024年6月在天津市中心妇产科医院妇科接收的84例卵巢癌恶性肿瘤患者纳入观察组,同期选取84例卵巢良性病变患者纳入对照组。对比两组患者临床资料及VEGF、α-HBDH水平的差异,分析VEGF、α-HBDH水平与卵巢癌恶性肿瘤患者临床特征的相关性。采用二元Logistics回归分析卵巢癌恶性肿瘤的独立危险因素,并采用受试者工作特征(ROC)曲线分析VEGF、α-HBDH水平诊断卵巢癌恶性肿瘤的价值。结果   观察组年龄、身体质量指数(BMI)及血清CA125、HE4、VEGF、α-HBDH水平显著高于对照组(P<0.05),VEGF与α-HBDH水平与国际妇产科联盟(FIGO)分期、分化等级及淋巴结转移均呈正相关关系(P<0.05)。将年龄、BMI、VEGF、α-HBDH作为自变量纳入二元Logistic回归,结果显示BMI、VEGF、α-HBDH是卵巢癌恶性肿瘤的影响因素(P<0.05),ROC曲线分析显示,联合检测VEGF和α-HBDH的AUC达0.921,灵敏度和特异度分别为81.0%和91.7%,优于单独检测(VEGF:AUC=0.702;α-HBDH:AUC=0.796)。结论  BMI联合VEGF与α-HBDH检测可为卵巢癌的诊断提供高效、无创的辅助手段,具有重要临床应用潜力
      Objective  To explore the  diagnostic value of clinical features combined with  peripheral  blood vascular endothelial growth factor(VEGF)and α-hydroxybutyrate dehydrogenase(α-HBDH)levels in ovarian cancer.Methods  A total of 84 patients with malignant ovarian cancer admitted to the gynecology department of Tianjin Central Hospital of Gynecology and Obstetrics from June 2022 to June 2024 were included in the observation group,and 84 patients with benign ovarian lesions during the same period were included in the control group.The clinical data and VEGF,α-HBDH levels of the two groups were compared.Pearson analysis was used to explore the correlation between VEGF,α-HBDH levels,and clinical characteristics of patients with malignant ovarian cancer.Binary Logistic regression analysis was conducted to identify independent risk factors for malignant ovarian cancer,and receiver operating characteristic(ROC) curves were used to analyze the diagnostic value of VEGF and α-HBDH levels for malignant ovarian cancer.Results  The observation group had significantly higher age,BMI,and serum CA125,HE4,VEGF,α-HBDH levels compared to the control group(P<0.05).VEGF and α-HBDH levels were significantly positively correlated with FIGO stage,differentiation grade,and lymph node metastasis(P<0.05).Age,BMI,VEGF,and α-HBDH were included as independent variables in binary Logistic regression,and the results showed that BMI,VEGF,and α-HBDH levelswere independent risk factors for malignant ovarian cancer(P<0.05).ROC curve analysis  revealed that the AUC for combined detection of VEGF and α-HBDH reached 0.921,with sensitivity and specificity of 81.0% and 91.7%,respectively,significantly superior to individual detection(VEGF:AUC=0.702;α-HBDH:AUC=0.796).Conclusions  The detection of BMI combined with VEGF and α-HBDH levels can provide an efficient and noninvasive auxiliary means for the diagnosis of ovarian cancer,which has important clinical application potential.
论著

CT、MRI影像学表现对原发性肝细胞癌微血管侵犯的诊断价值

Diagnostic value of CT and MRI imaging manifestations for microvascular invasion in primary hepatocellular carcinoma

:681-688
 
目的 探讨CT、MRI影像学表现对原发性肝细胞癌(HCC)微血管侵犯(MVI)的诊断价值。方法 选取2018年1月—2024年7月江门市第二人民医院(江门市中心医院蓬江分院)和江门市中心医院120例(共158个病灶)HCC患者,均行上腹部CT、MRI平扫+增强及弥散加权成像(DWI)检查;以术后病理结果为金标准。比较CT、MRI平扫+增强及DWI对HCC MVI诊断效能;分析HCC MVI诊断中CT、MRI平扫+增强及DWI检查与术后病理确诊结果之间的一致性;比较HCC MVI与无HCC MVI患者影像学表现及表观扩散系数(ADC)值。结果 DWI检查对HCC MVI的诊断效能(灵敏度、特异度、准确度、阳性预测值、阴性预测值)均显著性高于CT、MRI平扫+增强(P<0.05);CT、MRI、DWI对原发性肝细胞癌患者微血管侵犯的诊断效能比较,差异均无统计学意义(P>0.05)。在HCC MVI诊断效能中,CT、MRI影像学表现与术后病理确诊结果之间为中度一致性;DWI与术后病理确诊结果之间为高度一致性。HCC MVI患者的强化方式在非边缘动脉期强化、强化包膜、晕状强化、结中结、门脉分支癌栓占比均显著性高于无HCC MVI患者(P<0.05)。在不同b值(400、800、1 000、1 500 s/mm2)下,HCC MVI患者的ADC值均显著性高于无HCC MVI患者(P<0.05)。结论 CT、MRI平扫+增强及DWI对HCC MVI均具有较好的诊断效能,而MRI诊断结果与病理诊断一致性更佳,尤其DWI图中ADC值可更加精准地判断HCC的患者是否发生微血管侵犯,有助于指导临床医生建立“个体化”精准诊疗策略。
Objective To explore the diagnostic value of CT and MRI imaging manifestations for microvascular invasion(MVI)in primary hepatocellular carcinoma(HCC).Methods A total of 120 patients(158 lesions in total)with HCC in the Second People’s Hospital of Jiangmen(Pengjiang Branch of Jiangmen Central Hospital)and Jiangmen Central Hospital were selected from January 2018 to July 2024,all underwent CT and MRI plain + enhanced and diffusion-weighted imaging(DWI)of the upper abdomen;postoperative pathology Results was used as the diagnostic gold standard.The diagnostic efficacy of CT,MRI plain + enhanced and DWI for HCC MVI was compared.The concordance among CT,MRI plain + enhanced and DWI examinations with postoperative pathological diagnostic findings in the diagnosis of HCC MVI.Imaging manifestations and apparent diffusion coefficient(ADC)values in patients with and without HCC MVI were compared.Results Diagnostic effectiveness of DWI examination for HCC MVI(sensitivity,specificity,accuracy,positive predictive value,negative predictive value)were all significantly higher than those of CT and MRI plain + enhanced(P<0.05);none of the differences were statistically significant(P>0.05)in the comparison of diagnostic effectiveness of CT,MRI,and DWI for the diagnosis of MVI in patients with primary HCC.In HCC MVI diagnostic effectiveness,moderate concordance was found among CT,MRI imaging phenotypes and postoperative pathology Results;high concordance was found between DWI and postoperative pathology Results.In HCC MVI patients,the proportion of non-marginal arterial reinforcement,enhanced envelope,halo reinforcement,nodal in nodal and portal branch cancer thrombi was significantly higher than that in patients without HCC MVI(P<0.05).At different b-values(400,800,1 000,1 500 s/mm2),ADC values were all significantly higher in patients with HCC MVI than in patients without HCC MVI(P<0.05).Conclusions CT,MRI plain + enhanced and DWI have good diagnostic effectiveness for HCC MVI,while MRI diagnostic Results are in better concordance with pathologic diagnosis.In particular,ADC values in DWI maps can more accurately determine whether MVI occurs in patients with HCC,which helps to guide clinicians to establish“individualized”and precise diagnosis and treatment strategies.
出版者信息








《广州医药》公众号