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.
目的 探讨产前超声联合磁共振诊断胎儿部分性胼胝体发育不全的价值。方法 收集产前超声联合磁共振诊断为部分性胼胝体发育不全的胎儿15例,对比出生或引产后的检查结果,分析产前超声特征。结果 产前超声直接征象:胼胝体正中矢状切面相应部位缺失12例(12/15,80.0%)。间接征象:透明隔腔形态异常(80.0%)、侧脑室扩张(73.3%)、大脑纵裂池分离(73.3%)、脑中线丘脑后方囊性包块(26.7%)、侧脑室“泪滴状改变”(26.7%)、胼周动脉走行异常(26.7%),合并颅内或其他系统畸形6例。对比出生或引产后随访结果,诊断准确率:产前超声80.0%,产前磁共振93.3%。结论 超声可以诊断胎儿部分性胼胝体发育不全,更精确的诊断建议结合产前胎儿头颅磁共振检查。
Objective To explore the value of prenatal ultrasound in diagnosis of fetal partial agenesis of corpus callosum. Methods 15 fetuses diagnosed as partial agenesis of corpus callosum by prenatal ultrasound combined with magnetic resonance imaging (MRI) were collected. Results of examination after birth or induction of labor were compared to analyze the characteristics of prenatal ultrasound. Results Direct signs were observed in the prenatal sonographic features: 12 cases (12/15, 80.0%) were missing corresponding parts in the midsagittal section of corpus callosum. Indirect signs: transparent partition morphological abnormalities (80.0%), lateral ventricle expansion (73.3%), separation of longitudinal crack on the brain pool(73.3%), posterior thalamic midline cystic mass (26.7%), “teardrop change” of the lateral ventricle (26.7%), abnormal course of pericallosal artery (26.7%), with intracranial and other system deformity in 6 cases, including multiple anomalies. Compared with the follow-up results after birth or induction of labor, the diagnostic accuracy was 80.0% of prenatal ultrasound and 93.3% of prenatal MRI. Conclusion Ultrasonography may diagnose fetal partial agenesis of corpus callosum properly, and more accurate diagnosis could be finished combining with prenatal fetal cranial MRI.