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比较手部软组织肿块临床及影像学检查方法的诊断准确性

Comparing the Diagnostic Accuracy of Clinical and Radiological Measures in Hand Soft-Tissue Masses.

作者信息

Alzaidi Salman A, Shah Mardan Qutaiba N, Alotaibi Abrar, Elmoursy Mohamed

机构信息

Plastic and Reconstructive Surgery, King Faisal Medical Complex, Taif, SAU.

Plastic and Reconstructive Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.

出版信息

Cureus. 2020 Dec 18;12(12):e12145. doi: 10.7759/cureus.12145.

Abstract

Introduction Imaging modalities are imperative to aid in diagnosing hand soft-tissue tumors. Limited insight is available into the diagnostic accuracy of history and physical examination in comparison to radiological diagnosis.  Methods In this retrospective analysis, data of patients with hand soft-tissue tumors that were surgically treated and diagnosed through biopsy were extracted; taking this as a reference, the sensitivity, specificity and positive and negative predictive values and likelihood ratios of the clinical approach and radiological tools were contrasted against each other.  Results Data of a total of 34 patients were revised in this study. With a mean age of 40.1 years, the most common anatomical area of the hand to be affected by the tumors was the index (n = 7, (18.9%); ganglion cysts were the most common tumor (n = 9, 26.5%) and magnetic resonance imaging was the most commonly used imaging modality (n = 24, 70.6%). Clinical diagnosis scored a sensitivity and specificity of 44.4% and 100% in ganglion cysts and 62.5% and 86.2% in giant cell tumors in contrast to the sensitivity and specificity of 66.7% and 100% for ganglion cysts and 50% and 90% for giant cell tumors scored by radiological modalities. Conclusion Clinical diagnosis could be non-inferior to radiological diagnosis, yet radiological examination remains a valuable adjunct to clinical examination. Larger scale, prospective studies are required before generalizing our results.

摘要

引言 成像方式对于辅助诊断手部软组织肿瘤至关重要。与放射学诊断相比,关于病史和体格检查的诊断准确性的见解有限。方法 在这项回顾性分析中,提取了经手术治疗并通过活检确诊的手部软组织肿瘤患者的数据;以此为参考,对比了临床方法和放射学工具的敏感性、特异性、阳性和阴性预测值以及似然比。结果 本研究共纳入34例患者的数据。平均年龄为40.1岁,手部肿瘤最常累及的解剖部位是示指(n = 7,18.9%);腱鞘囊肿是最常见的肿瘤(n = 9,26.5%),磁共振成像(MRI)是最常用的成像方式(n = 24,70.6%)。与放射学方式对腱鞘囊肿的敏感性和特异性分别为66.7%和100%、对巨细胞瘤的敏感性和特异性分别为50%和90%相比,临床诊断对腱鞘囊肿的敏感性和特异性分别为44.4%和100%,对巨细胞瘤的敏感性和特异性分别为62.5%和86.2%。结论 临床诊断可能并不逊色于放射学诊断,但放射学检查仍是临床检查的重要辅助手段。在推广我们的结果之前,需要进行更大规模的前瞻性研究。

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本文引用的文献

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Should we be imaging soft tissue masses of the hand and wrist?我们是否应该对手部和腕部的软组织肿块进行成像检查?
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