摘要: |
目的 对比分析儿童肝脏未分化胚胎性肉瘤(UES)与间叶错构瘤(HMH)的声像图及临床特点,探讨超声对其的鉴别诊断价值。方法 收集我院经病理证实的19例UES患儿(UES组)与25例HMH患儿(HMH组),均行超声检查,分析两组超声表现及临床资料的差异。经二元Logistic回归分析筛选,将具有统计学意义的指标纳入受试者工作特征(ROC)曲线并分析其诊断效能。结果 两组在发病部位、囊实比例及瘤体大小比较差异均无统计学意义,在回声均匀与否、厚壁囊腔、病变内出血及年龄比较差异均有统计学意义(均P<0.05)。UES超声表现为实性区多为高低混杂不均回声,囊性区为多房分隔样,囊腔不规则,且无张力;HMH超声表现为实性区常为均匀偏高回声,囊腔较规则,囊壁有一定张力,亦可表现为一囊壁增厚的囊腔,即“厚壁囊腔”改变,此可看做HMH的特征性表现(这是属于HMH还是二者均有?)。二元Logistic回归分析显示,UES较HMH更易发生出血,且发病年龄明显高于HMH,差异均有统计学意义(均P<0.05);ROC曲线分析显示,病变内出血诊断UES的(什么的?)曲线下面积为0.861,敏感性84.2%,特异性88.0%;年龄鉴别二者的(什么的?)曲线下面积为0.931,敏感性89.5%,特异性88.0%,截断值为54个月。结论 超声在UES与HMH鉴别中具有重要的临床价值,结合患儿年龄及病变内是否出血,同时参考其回声特点,可对二者的鉴别做出提示。 |
关键词: 超声检查 未分化胚胎性肉瘤 间叶错构瘤;儿童;鉴别诊断 |
DOI: |
投稿时间:2022-04-10修订日期:2022-08-21 |
基金项目: |
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The differential diagnosis of ultrasound for undifferentiated embryonal sarcoma and hepatic mesenchymal hamartoma in children |
liuchengcheng,wangxiaoman,jialiqun |
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Abstract: |
Objective To compare and analyze the ultrasonographic images and clinical characteristics of undifferentiated embryonal sarcoma(UES)and Hepatic mesenchymal hamartoma (HMH),and to investigate the differential performance. Methods 19 cases of UES (UES group)and 25 cases of (HMH group) patients confirmed by pathologically in our hospital were collected, and everyone underwent ultrasonography. Analyze the differences in ultrasonographic and clinical features. By binary Logistic regression analysis,the statistically significant indicators were bring into the receiver operating characteristic (ROC) curve and the differential performance of every feature was evaluated. Results There were no statistically significant differences in site,proportion of cystic-solid complex and size between the two groups,but there were significant differences in homogeneity of echo,thick-walled cystic,bleeding and age (all P<0.05).In UES,the solid component is often inhomogeneous and complex hypoechoic. The cyst was multilocular,with irregular and no tension. While the HMH solid region is usually homogeneous and hyperechoic,with regular cavity and tension. It can also present as a cystic with thickened wall, that is, "thick-walled cystic", which can be seen as a unique characteristic of HMH. Binary Logistic regression analysis showed that UES was more prone to spontaneous hemorrhage,and the age was significantly higher than that of HMH(all P<0.05). ROC curve showed, that the area under the ROC(AUC) for UES diagnosed by bleeding was 0.861,with a sensitivity 84.2% and specificity 88.0%,and the AUC of the age was 0.931,with a sensitivity of 89.5% and a specificity of 88.0%,best cutoff was 54 months. Conclusion Ultrasound has important clinical value in the differential diagnosis of UES and HMH. Combined with age and bleeding,and reference to the characteristics of echo,the identification of these two diseases can be suggested. |
Key words: Ultrasonography Undifferentiated embryonal sarcoma Hepatic mesenchymal hamartoma Children Differential diagnosis |