Tagliafico Alberto, Truini Mauro, Spina Bruno, Cambiaso Paolo, Zaottini Federico, Bignotti Bianca, Calabrese Massimo, Derchi Lorenzo E, Martinoli Carlo
Institute of Anatomy, Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16138, Genoa, Italy,
Eur Radiol. 2015 Sep;25(9):2764-70. doi: 10.1007/s00330-015-3645-z. Epub 2015 Mar 21.
To evaluate diagnostic performance of ultrasound in the detection of local recurrences in patients with localized soft tissue sarcomas of the limb.
An analysis of patients treated for soft tissue sarcomas between 2005 and April 2014 was performed. Sixty-eight patients (men/women, 36:32; age range, 18-84 years) were evaluated. Sensitivity, specificity with 95% confidence intervals (CIs), positive predictive value (PPV), pre-test probability (the prevalence), negative predictive value (NPV), likelihood ratio for positive results (LH+), accuracy and post-test probability (post-P) of ultrasound were reported on a per patient basis using surgical findings and clinical follow-up as reference standard. Effects of independent variables (US equipment, age and sex, body mass index, radiologist) were considered. Comparison with MR was also performed.
The overall sensitivity and specificity were 0.88 (0.60-0.94) and 0.94 (0.86-0.98). PPV, pre-test probability, NPV, LH+, accuracy and post-P: 0.83/0.25/0.96/14.9/0.92/0.83. There were two false negative cases both graded as G3 and deeply located and three false positive US cases. Diagnostic accuracy was not dependent by US machine (p = 0.08), age and sex (p = 0.16), body mass index (p = 0.07) and radiologists (p = 0.07).
Diagnostic accuracy of ultrasound was relatively high. Negative US results excluded the presence of a local recurrence with acceptable accuracy.
• US accuracy is relatively high in sarcoma follow-up. • Negative US results exclude the presence of local recurrence with acceptable accuracy. • US may miss a small proportion of lesions. • False positive US cases are rare.
评估超声在检测肢体局限性软组织肉瘤患者局部复发方面的诊断性能。
对2005年至2014年4月间接受软组织肉瘤治疗的患者进行分析。共评估了68例患者（男/女，36:32；年龄范围18 - 84岁）。以手术结果和临床随访作为参考标准，逐例报告超声的敏感性、95%置信区间（CI）的特异性、阳性预测值（PPV）、检验前概率（患病率）、阴性预测值（NPV）、阳性结果似然比（LH+）、准确性和检验后概率（post - P）。考虑了自变量（超声设备、年龄和性别、体重指数、放射科医生）的影响。还与磁共振成像（MR）进行了比较。
总体敏感性和特异性分别为0.88（0.60 - 0.94）和0.94（0.86 - 0.98）。PPV、检验前概率、NPV、LH+、准确性和post - P分别为：0.83/0.25/0.96/14.9/0.92/0.83。有2例假阴性病例，均为G3级且位置较深，还有3例假阳性超声病例。诊断准确性不受超声设备（p = 0.08）、年龄和性别（p = 0.16）、体重指数（p = 0.07）及放射科医生（p = 0.07）的影响。
超声诊断准确性相对较高。超声检查结果为阴性时，以可接受的准确性排除了局部复发的存在。
• 超声在肉瘤随访中的准确性相对较高。• 超声检查结果为阴性时，以可接受的准确性排除了局部复发的存在。• 超声可能会漏诊一小部分病变。• 超声假阳性病例很少见。
