论文部分内容阅读
目的对比全身MRI与常规MR成像在检出儿童常见恶性肿瘤远处转移灶中的应用。材料与方法本多中心前瞻性研究符合HIPAA要求。经机构审查委员会批准,研究选择了188例病人(男109例,女79例;年龄1~21岁,平均10.2岁),他们新近被检出有淋巴瘤、神经母细胞瘤或软组织肉瘤病灶。所有病人签署了知情同意书并行非增强全身MRI及常规MR成像。10对阅片者集中阅片。一独立小组证实是否存在远处转移灶。用受试者操作特征曲线下面积(AUC)量化全身MRI和常规成像对转移灶的检出。分析肿瘤亚型、病人年龄、远端骨骼病变及肺部病变对于诊断准确性的影响。结果从134例符合要求的病人中选择了66例(33例转移灶阳性,33例阴性)来分析。与常规成像对转移灶的检出相比,全身MRI并不符合高检出准确度标准[平均AUC差异为20.03(95%CI:-0.10~0.04)]。然而,实体肿瘤的平均AUC显著高于淋巴瘤(P=0.006)。全身MRI比常规成像检出的骨骼转移灶更多(P=0.03),但肺转移灶检出少(P<0.001)。病人年龄并不影响准确度。结论对于儿童常见肿瘤病人远处转移灶的检出,与常规成像相比,全身MRI并不符合高检出准确度标准。但是对于非淋巴瘤的病人,全身MRI可以提高检出的准确度。
Objective To compare the application of whole-body MRI with conventional MR imaging in the detection of distant metastasis of common malignant tumors in children. Materials and Methods The multicenter prospective study conforms to HIPAA requirements. Approved by the Institutional Review Board, 188 patients (109 males and 79 females; ages 1 to 21 years, average 10.2 years) were selected for the study and were newly diagnosed with lymphoma, neuroblastoma or soft tissue sarcoma. All patients signed informed consent parallel non-enhanced whole body MRI and conventional MR imaging. 10 pairs of readers focus on reading. An independent panel confirmed the presence of distant metastases. The area under the receiver operating characteristic curve (AUC) was quantified using whole body MRI and routine imaging to detect metastases. Analysis of tumor subtype, patient age, distal skeletal lesions and lung lesions on the diagnostic accuracy. Results Of the 134 eligible patients, 66 (33 positive for metastases and 33 negative) were selected for analysis. Compared with routine imaging for the detection of metastases, whole body MRI does not meet the criteria for high detection accuracy [mean AUC difference of 20.03 (95% CI: -0.10 to 0.04)]. However, the mean AUC of solid tumors was significantly higher than that of lymphoma (P = 0.006). Whole body MRI detected more bone metastases than conventional imaging (P = 0.03), but fewer lung metastases were detected (P <0.001). The patient’s age does not affect the accuracy. Conclusion The detection of distant metastases in children with common tumor patients, compared with conventional imaging, the whole body MRI does not meet the high detection accuracy standards. However, for patients with non-lymphoma, whole body MRI can improve the accuracy of detection.