Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand.
Department of Pathology, Chiang Mai University, Chiang Mai, Thailand.
Curr Eye Res. 2021 Oct;46(10):1544-1550. doi: 10.1080/02713683.2021.1901938. Epub 2021 Mar 22.
: To assess and compare the diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) for detecting the extent of tumor invasion in eyes with advanced retinoblastoma prior to enucleation using histopathologic analysis as a reference.: A total of 56 patients (68 eyes) enucleated for retinoblastoma were reviewed. Eyes with complete data (CT 28, MRI 16) were included for analysis. Imaging data were reviewed by a pediatric radiologist, blinded to histopathology results. Four high-risk factors which included scleral, choroidal, anterior eye segment invasion, and postlaminar optic nerve invasion were assessed.: For CT, the diagnostic odds ratio (DOR), sensitivity, and specificity for detecting postlaminar optic nerve invasion were 1.7%, 25%, and 83.3%. Choroidal invasion was correctly identified in only 2 of 10 eyes (DOR 0.5, sensitivity 20%, specificity 66.7%). For scleral invasion, CT showed a diagnostic ratio of 1.5%, sensitivity 40%, specificity 69.6% whereas for anterior segment invasion DOR was 9.2%, sensitivity 100%, and specificity 65.4%. MRI showed a higher DOR for detecting postlaminar optic nerve invasion of 39%, sensitivity 77.8%, and specificity 100%. Choroidal and scleral invasion on MRI had a DOR of 6.5% (sensitivity 25%, specificity 100%) and 6% (sensitivity 33.3%, specificity 92.3%) respectively while DOR for anterior segment invasion was 1.3% (sensitivity 50%, specificity 57.1%).: CT showed a poor diagnostic accuracy for all four high-risk factors in advanced retinoblastoma and therefore may not be a useful tool for assessment of tumor extension. For MRI, detection of postlaminar optic nerve invasion was moderately accurate although less accurate for detection of other risk factors. Decision-making for each child should not be based on any single parameter but rather on consideration of clinical factors in combination with radiologic findings.
: 评估和比较磁共振成像 (MRI) 和计算机断层扫描 (CT) 在眼球摘除术前检测高级视网膜母细胞瘤肿瘤侵袭程度的诊断准确性，以组织病理学分析为参考。: 共回顾了 56 例（68 只眼）因视网膜母细胞瘤行眼球摘除术的患者。对具有完整数据的眼（CT 28 只，MRI 16 只）进行分析。影像学数据由一名儿科放射科医生进行评估，该医生对组织病理学结果不知情。评估了四个高危因素，包括巩膜、脉络膜、眼前段侵犯和视神经后段侵犯。: CT 对视神经后段侵犯的诊断优势比（DOR）、敏感性和特异性分别为 1.7%、25%和 83.3%。只有 10 只眼中的 2 只眼正确识别出脉络膜侵犯（DOR 0.5，敏感性 20%，特异性 66.7%）。对于巩膜侵犯，CT 显示诊断比为 1.5%，敏感性为 40%，特异性为 69.6%，而对于前段侵犯，DOR 为 9.2%，敏感性为 100%，特异性为 65.4%。MRI 检测视神经后段侵犯的 DOR 较高，为 39%，敏感性为 77.8%，特异性为 100%。MRI 上的脉络膜和巩膜侵犯的 DOR 分别为 6.5%（敏感性 25%，特异性 100%）和 6%（敏感性 33.3%，特异性 92.3%），而前段侵犯的 DOR 为 1.3%（敏感性 50%，特异性 57.1%）。: CT 对高级视网膜母细胞瘤的所有四个高危因素的诊断准确性均较差，因此可能不是评估肿瘤延伸的有用工具。对于 MRI，视神经后段侵犯的检测具有中等准确性，尽管对其他危险因素的检测准确性较低。对每个孩子的决策不应基于任何单一参数，而应考虑临床因素与影像学发现相结合。
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