常规MRI联合SWI序列在眼球内病变诊断及鉴别中的价值
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摘要
目的探讨常规MRI联合SWI序列在眼球病变中的诊断及鉴别诊断价值。方法收集眼球内病变37例。由两名不知病理的影像科医生分别对常规MRI及常规MRI结合SWI序列进行分析,并与病理结果进行对照,通过Kappa检验及McNemar检验分析常规MRI与常规MRI结合SWI序列对眼球内病变诊断阳性率。结果眼球内病变37例,SWI序列眼球内病变钙化成分的诊断符合率为88.9%,对眼球内病变出血的诊断符合率为99.9%,常规MRI与常规MRI结合SWI序列在诊断眼球内病变的诊断结果一致性较差(Kappa=0.140,P=0.096),常规MRI联合SWI序列诊断阳性率为97.3%,明显高于常规MRI诊断(73.0%),且差别具有统计学意义(P=0.004)。观察者在观察常规MRI序列时观察者间一致性为较好(k=0.754,P<0.001),常规MRI结合SWI序列时观察者间一致性为一般(k=0.471,P=0.004)。结论常规MRI结合SWI序列在诊断眼球内病变方面诊断效能明显高于常规MRI。
Objective To evaluate the value of routine MRI combined with SWI sequence in diagnosis and differential diagnosis of ocular diseases. Methods 37 cases of intraocular lesions were collected. The conventional MRI images and conventional MRI combined with SWI sequences were analyzed by two imaging doctors who did not know the pathology, and the results were compared with the pathological results. Kappa test and Mcnemar test were used to analyze the positive rate of routine MRI and routine MRI combined with SWI sequence in the diagnosis of intraocular diseases. Results In 37 cases of intraocular lesions, the diagnostic coincidence rate of calcification components in intraocular lesions of SWI sequence was 88.9% and that of hemorrhage in intraocular lesions was 99.9%. The diagnostic results of routine MRI combined with conventional MRI combined with SWI sequence were pvor consistent(kappa=0.140, P=0.096). The positive rate of routine MRI combined with SWI sequence was 97.3%, which was significantly higher than that of routine MRI diagnosis(73.0%). The difference was statistically significant(P=0.004). The consistency between observers was good in observing conventional MRI sequences(k=0.754, P<0.001), and in conventional MRI imaging combined with SWI sequences it was normal(k=0.471, P=0.004). Conclusion Conventional MRI combined with SWI sequence is more effective than conventional MRI in the diagnosis of intraocular lesions.
Objective To evaluate the value of routine MRI combined with SWI sequence in diagnosis and differential diagnosis of ocular diseases. Methods 37 cases of intraocular lesions were collected. The conventional MRI images and conventional MRI combined with SWI sequences were analyzed by two imaging doctors who did not know the pathology, and the results were compared with the pathological results. Kappa test and Mcnemar test were used to analyze the positive rate of routine MRI and routine MRI combined with SWI sequence in the diagnosis of intraocular diseases. Results In 37 cases of intraocular lesions, the diagnostic coincidence rate of calcification components in intraocular lesions of SWI sequence was 88.9% and that of hemorrhage in intraocular lesions was 99.9%. The diagnostic results of routine MRI combined with conventional MRI combined with SWI sequence were pvor consistent(kappa=0.140, P=0.096). The positive rate of routine MRI combined with SWI sequence was 97.3%, which was significantly higher than that of routine MRI diagnosis(73.0%). The difference was statistically significant(P=0.004). The consistency between observers was good in observing conventional MRI sequences(k=0.754, P<0.001), and in conventional MRI imaging combined with SWI sequences it was normal(k=0.471, P=0.004). Conclusion Conventional MRI combined with SWI sequence is more effective than conventional MRI in the diagnosis of intraocular lesions.
引文
[1] Rodjan F,de Graaf P,van der Valk P.Detection of calcifications in retinoblastoma using gradient echo MR imaging sequences:comparative study between in vivo MR imaging and ex vivo high-resolution CT [J].AJNR,2015,36(2):355-360.
[2] Ana Marija Franceschi,Stergios J,Moschos Carey K.Anders use of susceptibility-weighted imaging (SWI) in the detection of brain hemorrhagic metastases from breast cancer and melanoma [J].J Comput Assist Tomogr,2016 ,40(5):803-805.
[3] 胡晓栋,纪盛章,陈胜利.磁敏感加权成像在检出颅内钙化中的应用价值[J].实用医学杂志,2014 ,30(15):2470-2471.
[4] Mittal Z,Wu J,Neelavalli E.Susceptibility-weighted imaging:techn ical aspects and clinical applications [J].AJNR,2009,30(2):232-252.
[5] Haacke EM,Mittal S,Wu Z,et al.Susceptibility-weighted imaging:technical aspects clinical applications[J].AJNR,2009,30(1):19-30.
[6] Reith W,Yilmaz U Orbita.Teil1:Anatomie,bildgebende verfahren undretrobulbre laionen [J].Radiologe,2015,55(3):701-720.
[7] Berin Tarlan,Hayyam Kratl.Uveal melanoma:current trends in diagnosis and management [J].Turk J Ophthalmol,2016,46(1):123-137.
[8] Giulio Zuccoli,Ashok Panigrahy,Anshul Haldipur.Susceptibility weighted imaging depicts retinal hemorrhagesin abusive head trauma [J].Neuroradiology,2013,55(7):889-893.
[9] Weiwei Chen,Wenzhen Zhu,IIhami Kovanlikaya.Intracranial calcifications and hemorrhages:characterization quantitative susceptibility mapping [J].Radiology,2014,270(2):496-505.
[10] Jaime Levy,Shahar Frenkel,Mario Baras.Calcification in retinoblastoma:histopathologic findings and statistical analysis of 302 cases [J].Br J Ophthalmol,2011,95(8):1145-1150.
[11] Lourdes R,Ylagan MD,F.I.A.C.Intraocular pigmented proliferations in the context of cytologic evaluation [J].Diagn Cytopathol,2009,37(11):853-864.
[12] Grech R,Cornish KS,Galvin PL ,et al.Imaging of adult ocular and orbital pathology-a pictorial,review[J].J Radiol Case Rep,2014,8(2):1-29.
[2] Ana Marija Franceschi,Stergios J,Moschos Carey K.Anders use of susceptibility-weighted imaging (SWI) in the detection of brain hemorrhagic metastases from breast cancer and melanoma [J].J Comput Assist Tomogr,2016 ,40(5):803-805.
[3] 胡晓栋,纪盛章,陈胜利.磁敏感加权成像在检出颅内钙化中的应用价值[J].实用医学杂志,2014 ,30(15):2470-2471.
[4] Mittal Z,Wu J,Neelavalli E.Susceptibility-weighted imaging:techn ical aspects and clinical applications [J].AJNR,2009,30(2):232-252.
[5] Haacke EM,Mittal S,Wu Z,et al.Susceptibility-weighted imaging:technical aspects clinical applications[J].AJNR,2009,30(1):19-30.
[6] Reith W,Yilmaz U Orbita.Teil1:Anatomie,bildgebende verfahren undretrobulbre laionen [J].Radiologe,2015,55(3):701-720.
[7] Berin Tarlan,Hayyam Kratl.Uveal melanoma:current trends in diagnosis and management [J].Turk J Ophthalmol,2016,46(1):123-137.
[8] Giulio Zuccoli,Ashok Panigrahy,Anshul Haldipur.Susceptibility weighted imaging depicts retinal hemorrhagesin abusive head trauma [J].Neuroradiology,2013,55(7):889-893.
[9] Weiwei Chen,Wenzhen Zhu,IIhami Kovanlikaya.Intracranial calcifications and hemorrhages:characterization quantitative susceptibility mapping [J].Radiology,2014,270(2):496-505.
[10] Jaime Levy,Shahar Frenkel,Mario Baras.Calcification in retinoblastoma:histopathologic findings and statistical analysis of 302 cases [J].Br J Ophthalmol,2011,95(8):1145-1150.
[11] Lourdes R,Ylagan MD,F.I.A.C.Intraocular pigmented proliferations in the context of cytologic evaluation [J].Diagn Cytopathol,2009,37(11):853-864.
[12] Grech R,Cornish KS,Galvin PL ,et al.Imaging of adult ocular and orbital pathology-a pictorial,review[J].J Radiol Case Rep,2014,8(2):1-29.