MRI、术中超声造影及两种方法联合在脑胶质瘤初步分级中诊断准确性及一致性的探讨

摘要

目的:探讨 MRI、术中超声造影及两种方法联合在脑胶质瘤初步分级中的应用价值.方法 对术前经MRI、术中超声造影诊断并被病理证实为胶质瘤的80例患者的病例资料进行回顾性分析,总结不同级别胶质瘤胶质瘤在两种检查方法中的影像学特征,评价两种方法及两种方法联合在诊断不同级别胶质瘤中的价值,并分别探讨两种检查方法以及两种方法联合与病理结果相比在诊断不同级别胶质瘤的一致性.结果 不同级别胶质瘤具有不同的影像学特征,MRI诊断不同级别胶质瘤的灵敏度为75.0%,特异度为80.0%,诊断准确性77.5%,术中超声造影(CEUS)诊断不同级别胶质瘤的灵敏度为73.3%,特异度为91.4%,诊断准确性81.25%,MRI与CEUS联合诊断不同级别胶质瘤的灵敏度为84.4%,特异度为91.4%,诊断准确性87.5%,MRI与病理结果的一致性中等(K =0.549,Sk=0.093),CEUS与病理结果的一致性好(K=0.630,Sk=0.084),CEUS与MRI联合与病理结果的一致性中等(K = 0.749,Sk =0.074).结论 CEUS与 MRI联合检查能够提高诊断不同级别胶质瘤的准确率,能为胶质瘤的诊断及初步分级提供参考依据.%Objective To discussion the application value of MRI,intraoperative contrast-enhanced ultrasound and two kinds of methods in the primary grading of brain gliomas.Methods The retrospective analysis was performed on 80 cases of brain glioma who were diagnosed by preoperative MRI,intraoperative ultrasonography and confirmed by pathology.The imaging features of gliomas of different grades were summarized in the two methods.The two methods and the combination of the two methods in the diagnosis of different grades of gliomas were evaluated to explore the consistency of two methods or the combination of two methods with the pathological results in the diagnosis of different levels of glioma consistency. Results Different grade gliomas have different imaging features.The sensitivity and specificity of MRI in the diagnosis of gliomas of different grades were 75%,and the specificity was 80%,and the diagnostic accuracy was 77.5%.The sensitivity and specificity of CEUS in the diagnosis of gliomas of different grades were 73.3%,91.4% respectively,and the diagnostic accuracy was 81.25%.The sensitivity of MRI combined with CEUS in the diagnosis of different grade gliomas was 84.4%,and the specificity was 91.4%, and the diagnostic accuracy was 87.5%.MRI and pathological results were medium consistent(K =0.549, Sk =0.093).CEUS and pathological results showed high consistency(K =0.630,Sk =0.084).The combination of CEUS and MRI with pathological results showed medium consistency.Conclusion CEUS combined with MRI can improve the accuracy of diagnosis of different levels of glioma.It can also provide a reference for the diagnosis and grading of gliomas.