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CT及MRI对中枢神经系统神经母细胞瘤的诊断价值

作者:于 山

所属单位:河南省商丘市永城市人民医院影像科(河南 商丘 476600)

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摘要

目的探讨CT及MRI对中枢神经 系统神经母细胞瘤的诊断价值。方法 回 顾性分析2012年10月-2017年10月我院 收治的96例高度怀疑中枢神经系统神经 母细胞瘤患儿的临床资料。将行CT检查 的42例患儿纳入A组,行MRI检查的54例 患儿纳入B组,两组患者均接受手术治 疗,并行病理检查。以病理检查结果为 “金标准”评价CT及MRI对中枢神经系 统神经母细胞瘤的诊断价值,并分析该 疾病的CT、MRI影像学特点。结果 术后 病理检查结果显示:A组患儿中37例被 确诊为中枢神经系统神经母细胞瘤,B 组患儿中48例被确诊为中枢神经系统神 经母细胞瘤。CT诊断中枢神经系统神经 母细胞瘤的灵敏度为86.49%(32/37), 特异度为80.00%(4/5),准确 率为85.71%(36/42);MRI诊断 中枢神经系统神经母细胞瘤的 灵敏度为87.50%(42/48),特异 度为66.67%(4/6),准确率为 85.19%(46/54)。结论 CT和MRI对中枢神 经系统神经母细胞瘤的诊断准确性均较 高,在临床应用价值较高。

Objective To explore the diagnostic value of CT and MRI in neuroblastoma of central nervous system. Methods The clinical data of 96 cases of children patients with highly suspected neuroblastoma of central nervous system in our hospital from October 2012 to October 2017 were retrospectively analyzed. 42 cases who underwent CT examination were included in the A group, and 54 cases who underwent MRI examination were included in the B group, and the two groups were given surgery and pathological examination. The results of pathological examination were taken as "gold standard" to evaluate the diagnostic value of CT and MRI for neuroblastoma of central nervous system and to analyze the CT and MRI imaging features. Results Postoperative pathological examination showed that 37 cases in the A group were diagnosed with neuroblastoma of central nervous system and 48 cases in the B group. The sensitivity, specificity and accuracy in the diagnosis of neuroblastoma of central nervous system were 86.49% (32/37), 80.00% (4/5) and 85.71% (36/42) by CT and were 87.50% (42/48), 66.67% (4/6) and 85.19% (46/54) by MRI. Conclusion CT and MRI for neuroblastoma of central nervous system have high diagnostic accuracy and have high value in clinical application.

【关键词】CT;MRI;中枢神经系统; 神经母细胞瘤;诊断价值

【中图分类号】R739.41;R445.2;R445.3

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2018.10.007

前言

中枢神经系统神经母细胞瘤(又称神经细胞瘤)以呕吐、头痛、颅 内压增高为主要临床表现,多发于婴幼儿和儿童,成人少见。根据世 界卫生组织(WTO)对中枢神经系统肿瘤的分类和分级,神经细胞瘤被划 分为Ⅳ级中枢神经系统胚胎性肿瘤,是一种儿童高度恶性肿瘤[1]。原 发性神经细胞瘤多发于脑实质(多见于顶叶、颞叶、额叶)或椎管内、 松果体、侧脑室,继发性肿瘤则可位于颅脑任何部位,多起源于肾上 腺及交感神经链区域,可沿脑膜和脑脊液扩散[2]。临床上治疗该恶性 肿瘤的最佳方案是手术完整切除,术后辅以放化疗,经术后组织病理 检查可对肿瘤进行准确的诊断,但如何提高术前诊断准确性一直是临 床研究的重要课题之一[3]。本研究旨在探讨CT及MRI对中枢神经系统神 经母细胞瘤的诊断价值,现报道如下。