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CT成像参数在盆腔脂肪增多症中的诊断准确性

Diagnostic accuracy of CT imaging parameters in pelvic lipomatosis.

作者信息

Bai Xin, Zhang Gumuyang, Xu Lili, Zhang Xiaoxiao, Zhang Xuebin, Jin Zhengyu, Sun Hao

机构信息

Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Wangfujing Street, Dongcheng District, Beijing, 100730, China.

Department of Urology Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Wangfujing Street, Dongcheng District, Beijing, 100730, China.

出版信息

Abdom Radiol (NY). 2021 Jun;46(6):2779-2788. doi: 10.1007/s00261-020-02946-0. Epub 2021 Jan 28.

Abstract

PURPOSE

To predict the diagnosis of pelvic lipomatosis (PL) by assessing CT imaging parameters.

METHODS

Fifty clinically proven PL patients and 50 controls were included. Two radiologists recorded the types of bladder shapes and measured the following CT imaging parameters: (1) pelvic fat volume (PFV); (2) a set of morphological indices of bladder and rectosigmoid, including the ratio of craniocaudal to anterior-posterior length of bladder (CC/AP), angle between anterior and posterior wall (AAP), relative length of posterior urethra (rLPU), right and left angles between bladder and seminal vesicle (RABS and LABS), distance from verumontanum to anterior wall of rectum (DVR) and rectosigmoid morphological index (RMI). Secondary complications were also noted.

RESULTS

The results were evaluated by an unpaired t test, ROC analysis and logistic regression. All CT imaging parameters except RMI (p = 1.000) indicated a statistical difference between PL and controls (p < 0.01). The AUCs of these parameters were between 0.724 (for rLPU) and 0.993 (for AAP). The sensitivity and specificity were 94% and 98% for AAP and 92% and 94% for the combined model, respectively. 23 patients were pathologically diagnosed with cystitis glandular. The incidence of hydronephrosis in the PL group was higher than that in the control group (p < 0.01).

CONCLUSION

CT imaging parameters can predict the diagnosis of PL. The combined model of objective parameters including PFV, rLPU and DVR showed the best diagnostic performance for PL.

摘要

目的

通过评估CT成像参数预测盆腔脂肪增多症(PL)的诊断。

方法

纳入50例临床确诊的PL患者和50例对照。两名放射科医生记录膀胱形态类型并测量以下CT成像参数:(1)盆腔脂肪体积(PFV);(2)一组膀胱和直肠乙状结肠的形态学指标,包括膀胱头尾径与前后径之比(CC/AP)、前后壁夹角(AAP)、后尿道相对长度(rLPU)、膀胱与精囊的左右夹角(RABS和LABS)、前列腺尖至直肠前壁的距离(DVR)以及直肠乙状结肠形态学指标(RMI)。还记录了继发性并发症。

结果

通过非配对t检验、ROC分析和逻辑回归对结果进行评估。除RMI外(p = 1.000),所有CT成像参数在PL组和对照组之间均显示出统计学差异(p < 0.01)。这些参数的AUC在0.724(rLPU)至0.993(AAP)之间。AAP的敏感性和特异性分别为94%和98%,联合模型的敏感性和特异性分别为92%和94%。23例患者经病理诊断为腺性膀胱炎。PL组肾盂积水的发生率高于对照组(p < 0.01)。

结论

CT成像参数可预测PL的诊断。包括PFV、rLPU和DVR在内的客观参数联合模型对PL显示出最佳诊断性能。

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