Santiago Medina L, al-Orfali M, Zurakowski D, Poussaint T Y, DiCanzio J, Barnes P D
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45236, USA.
Radiology. 1999 Jun;211(3):767-71. doi: 10.1148/radiology.211.3.r99jn09767.
To compare fast screening and conventional magnetic resonance (MR) imaging for the detection of occult dysraphic myelodysplasias in children and young adults.
A retrospective case-control study included 101 patients (mean age, 4.9 years; range, 1 day to 26 years) suspected of having occult lumbosacral dysraphism. Sixty case patients had myelodysplastic lesions (19 filar lipoma, 14 syringomyelia, 10 intradural lipoma, eight dermal sinus, five diastematomyelia, five lipomyelomeningocele, two caudal regression syndrome); 41 control patients had no dysraphic lesions; 17 patients had associated renal anomalies. Two neuroradiologists reviewed MR images from conventional and fast screening protocols. Diagnostic performance parameters included sensitivity, specificity, and area under the receiver operating characteristic curve (Az value).
The sensitivity of conventional and fast screening MR studies was 97.1% and 98.5%, respectively, the specificity was 90.9% and 84.8%, respectively. The Az value was 0.973 for the fast screening and 0.976 for the conventional MR studies (P = .83). Interobserver agreement was very good for fast screening images (kappa = 0.68) and excellent for conventional images (kappa = 0.75). For renal anomalies, the Az value was 0.786 and 0.853 for fast screening and conventional MR imaging, respectively (P = .28).
Conventional three-plane lumbosacral MR imaging in children and young adults suspected of having occult dysraphism provides better diagnostic information than does fast screening two-plane MR imaging because of its higher specificity and interobserver agreement.
比较快速筛查磁共振成像（MR）与传统MR成像在检测儿童及青年隐匿性脊髓发育不良中的应用。
一项回顾性病例对照研究纳入了101例疑似隐匿性腰骶部脊髓发育不良的患者（平均年龄4.9岁；范围1天至26岁）。60例病例患者存在脊髓发育不良性病变（19例终丝脂肪瘤、14例脊髓空洞症、10例硬脊膜内脂肪瘤、8例皮样窦、5例脊髓纵裂、5例脂肪脊髓脊膜膨出、2例尾椎退化综合征）；41例对照患者无脊髓发育不良性病变；17例患者伴有肾脏异常。两名神经放射科医生回顾了传统及快速筛查方案的MR图像。诊断性能参数包括敏感性、特异性及受试者操作特征曲线下面积（Az值）。
传统MR研究和快速筛查MR研究的敏感性分别为97.1%和98.5%，特异性分别为90.9%和84.8%。快速筛查的Az值为0.973，传统MR研究的Az值为0.976（P = 0.83）。观察者间一致性对于快速筛查图像非常好（kappa = 0.68），对于传统图像则优秀（kappa = 0.75）。对于肾脏异常，快速筛查和传统MR成像的Az值分别为0.786和0.853（P = 0.28）。
对于疑似隐匿性脊髓发育不良的儿童及青年，传统的腰骶部三平面MR成像因其更高的特异性和观察者间一致性，比快速筛查的两平面MR成像能提供更好的诊断信息。
