Morosi C, Stacchiotti S, Marchianò A, Bianchi A, Radaelli S, Sanfilippo R, Colombo C, Richardson C, Collini P, Barisella M, Casali P G, Gronchi A, Fiore M
Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Eur J Surg Oncol. 2014 Dec;40(12):1662-70. doi: 10.1016/j.ejso.2014.10.005. Epub 2014 Oct 15.
Aim of study was to assess the correlation between computed tomography scan (CT) findings and histopathology.
Data were collected on consecutive patients with suspected retroperitoneal sarcoma (RPS) referred to a tertiary sarcoma center. Patients underwent contrast enhanced multi-detector CT scans. Radiological features of lesions were classified according to the presence of a fatty (Group A) mass, or non-fatty (Group B) mass, both subdivided according to homogeneity and intralesional high-contrasted appearance. Radiological classification was compared with histopathological diagnosis. Sensitivity, specificity, positive/negative predictive value (PPV, NPV) were analyzed.
Of 291 patients, 103/291 (35.4%) masses were classified in Group A and 188/291 (64.6%) in Group B. Diagnosis of mesenchymal tumor was obtained in 231/291 cases (79%) and non-mesenchymal tumor in 60/291 (21%). Sensitivity and specificity of Group A for liposarcoma were 76.7% and 92.0%; PPV and NPV were 86.4% and 85.6%. Sensitivity of Group B for a mesenchymal tumor was 55.4% and specificity was 0%; PPV and NPV were 68.1% and 0%.
None of radiological criteria were sufficient to anticipate a specific diagnosis, with the only exception of well differentiated liposarcoma and angiomyolipoma. In a series of suspected RPS, 21% of the lesions were finally non-mesenchymal tumors.
本研究旨在评估计算机断层扫描(CT)结果与组织病理学之间的相关性。
收集转诊至三级肉瘤中心的连续疑似腹膜后肉瘤(RPS)患者的数据。患者接受了对比增强多排CT扫描。根据是否存在脂肪性肿块(A组)或非脂肪性肿块(B组)对病变的放射学特征进行分类,两组均根据均匀性和病灶内高对比度表现进一步细分。将放射学分类与组织病理学诊断进行比较。分析敏感性、特异性、阳性/阴性预测值(PPV、NPV)。
291例患者中,103/291(35.4%)个肿块分类为A组,188/291(64.6%)个肿块分类为B组。231/291例(79%)诊断为间叶性肿瘤,60/291例(21%)诊断为非间叶性肿瘤。A组对脂肪肉瘤的敏感性和特异性分别为76.7%和92.0%;PPV和NPV分别为86.4%和85.6%。B组对间叶性肿瘤的敏感性为55.4%,特异性为0%;PPV和NPV分别为68.1%和0%。
除高分化脂肪肉瘤和平滑肌瘤外,没有任何放射学标准足以预测特定诊断。在一系列疑似RPS病例中,21%的病变最终被诊断为非间叶性肿瘤。