| 摘要: |
| 目的 分析眼眶及眼附件淋巴瘤临床、超声声像图特征。方法 回顾性分析本院2017.01~2021.09眼眶及眼附件淋巴瘤(79例)与炎性假瘤(68例)患者的临床、超声资料,将有统计学意义的特征进行二分类logistic回归分析,建立预测模型,鉴别淋巴瘤与炎性假瘤。并对比分析超声与磁共振的诊断符合率。结果 淋巴瘤与炎性假瘤比较,年龄、性别、病变累及象限数目、肿瘤最大径、内部回声、形态、边界、纵横比、内见强回声、肿瘤呈“铸型”、肿瘤呈“倒三角形”存在显著性差异(P＜0.05)；多因素logistic回归提示, Logit(P)=-4.426+1.506年龄≥57.5岁+1.473男性+1.732内部回声(低/极低/近无)+1.888铸型+1.356内部见点线网状强回声+1.111内部不均匀。模型曲线下面积0.913,当以Logit(P)≥0.556判断为淋巴瘤,Logit(P)＜0.556判断为炎性假瘤,灵敏度82.9%,特异度89.7%,约登指数0.720。超声与磁共振诊断符合率84.9%。结论 眼眶及眼附件淋巴瘤具有特征的超声表现,结合临床、超声特征建立的诊断模型对眼眶及眼附件淋巴瘤诊断与鉴别诊断具有临床意义,超声与磁共振诊断有一定的一致性。 |
| 关键词: 眼眶及眼附件淋巴瘤 超声 眼眶肿瘤 眼眶炎性假瘤 |
| DOI： |
| 投稿时间：2022-11-14修订日期：2022-11-26 |
| 基金项目:重庆市影像医学与核医学临床医学研究中心(CSTC2015YFPT-gcjsyjzx0175)；重庆市技术创新与应用示范社会民生类一般项目(cstc2018jscx-msybX0018)；陆军特色医学中心人才创新能力培养项目(2019CXJXC014) |
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| Differential diagnosis of orbital and adnexal lymphoma and inflammatory pseudotumour: a comparativestudy of clinical , ultrasound and MRI |
| huangyouyi,bijie,chenxiao,litao |
| (Daping Hospital，Army Medical University) |
| Abstract: |
| Objective To analyze the clinical, ultrasound Sonogram features of orbital and adnexal lymphomas. Methods The clinical, ultrasound data of patients with orbital and adnexal lymphoma (79 cases) and orbital inflammatory pseudotumor (68 cases) from January, 2017 to September, 2021 were retrospectively analyzed. And statistically significant features were subjected to binary logistic regression analysis to establish a prediction model for distinguishing lymphoma from orbital inflammatory pseudotumor. The diagnostic accordance rate of ultrasound and MRI was also compared and analyzed. Results When comparing lymphoma with orbital inflammatory pseudotumor, there were significant differences in age, gender, lesion involves the number of quadrants, maximum tumor diameter, internal echogenicity, morphology, border, aspect ratio, internal strong echogenicity, "cast" tumor and "inverted triangle" tumor (P<0.05); as suggested by multivariate logistic regression, Logit (P) = -4.426 + 1.506 age ≥ 57.5 years + 1.473 male + 1.732 internal echogenicity (low/very low/nearly absent) + 1.888 casts + 1.356 strong internal dotted-line reticular echogenicity + 1.111 internal inhomogeneity. The area under the model curve was 0.913, and when judged as lymphoma by Logit (P) ≥ 0.556 and orbital inflammatory pseudotumor by Logit (P) < 0.556, the sensitivity was 82.9%, specificity 89.7%, and Youden index 0.720. The diagnostic accordance rate between ultrasound and MRI was 84.9% . Conclusion Orbital and adnexal lymphoma has characteristic ultrasound manifestations. The diagnostic model established by combining clinical and ultrasound features has clinical significance for the diagnosis and identifying of orbital lymphoma, and there is some agreement between ultrasound and MRI diagnosis. |
| Key words: orbital and adnexal lymphoma(OAL) ultrasound orbital tumor orbital inflammatory pseudotumor (OIP) |
