多层螺旋CT对不明来源盆腔肿瘤供血动脉重建的诊断价值

Tumor feeding artery reconstruction with multislice spiral CT in the diagnosis of pelvic tumors of unknown origin.

作者信息

Hu Hai-Jing, Huang Yong-Wen, Zhu Ying-Chang

机构信息

From the Departments of Radiology (H.H.) and Surgery (Y.Z. e-mail:

出版信息

Diagn Interv Radiol. 2014 Jan-Feb;20(1):9-16. doi: 10.5152/dir.2013.12176.

DOI:10.5152/dir.2013.12176

PMID:24100058

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4463243/

Abstract

PURPOSE

We aimed to compare multislice spiral computed tomography (MSCT) angiography diagnosis with both surgical findings and postoperative pathological results in patients with pelvic tumors of unknown origin. In addition, the diagnostic accuracy of MSCT angiography was compared with that of routine computed tomography for tumor feeding artery volume reconstruction to determine the origin and nature of pelvic tumors.

MATERIALS AND METHODS

The records of 43 patients with pelvic tumors of unknown origin who underwent MSCT angiography were retrospectively reviewed. Volume reconstructions using add vessel and merge views methods were performed for abdominal and pelvic blood vessels. The tumor origin was identified based on observations of the origin, number, morphology, starting/ending locations, route, and distribution of the tumor feeding arteries.

RESULTS

Overall, the mean tumor diameter was 9.8±3.5 cm (range, 4.2-23.5 cm); 11 tumors (25.6%) were cystic in nature; and 32 tumors (74.4%) were either solid/cystic or solid in nature. When considering all MSCT angiography examinations used to predict the nature of the tumor (e.g., malignant or benign), the sensitivity and specificity were 77.3% and 95.2%, respectively. The positive and negative predictive values were 94.4% and 80%, respectively. The overall diagnostic accuracy was 86.05% with an area under the curve of 0.961 (95% confidence interval, 0.913-1.000).

CONCLUSIONS

MSCT angiography volume reconstruction for pelvic tumor feeding arteries of unknown origin is highly valuable for localization, qualitative diagnosis, and quantitative diagnosis of pelvic tumors.

摘要

目的

我们旨在比较多层螺旋计算机断层扫描（MSCT）血管造影诊断与手术发现以及未知起源盆腔肿瘤患者术后病理结果。此外，将MSCT血管造影的诊断准确性与常规计算机断层扫描对肿瘤供血动脉容积重建的诊断准确性进行比较，以确定盆腔肿瘤的起源和性质。

材料与方法

回顾性分析43例接受MSCT血管造影的未知起源盆腔肿瘤患者的记录。对腹部和盆腔血管采用添加血管和融合视图方法进行容积重建。根据肿瘤供血动脉的起源、数量、形态、起始/终止位置、走行和分布来确定肿瘤起源。

结果

总体而言，肿瘤平均直径为9.8±3.5 cm（范围4.2 - 23.5 cm）；11个肿瘤（25.6%）为囊性；32个肿瘤（74.4%）为实性/囊性或实性。在考虑所有用于预测肿瘤性质（如恶性或良性）的MSCT血管造影检查时，敏感性和特异性分别为77.3%和95.2%。阳性和阴性预测值分别为94.4%和80%。总体诊断准确性为86.05%，曲线下面积为0.961（95%置信区间，0.913 - 1.000）。