| 蒋吉美 张皓 罗禹 周永明.中耳胆脂瘤的影像诊断：高分辨率计算机断层成像与磁共振成像的比较研究[J].,2015,15(9):1700-1704 |
| 中耳胆脂瘤的影像诊断：高分辨率计算机断层成像与磁共振成像的比较研究 |
| Imaging Diagnosis of Middle Ear Cholesteatoma:Comparative Study on High Resolution Computed Tomography andMagnetic Resonance Imaging |
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| DOI： |
| 中文关键词: 中耳胆脂瘤 高分辨率CT 磁共振成像 |
| 英文关键词: Middle ear cholesteatoma High-resolution CT Magnetic resonance imaging |
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| 中文摘要: |
| 目的：评估和比较高分辨率计算机断层成像(high resolution computer tomography, HRCT)与磁共振成像(magnetic resonance
imaging, MRI)对中耳胆脂瘤的诊断价值。方法：回顾性分析临床初步诊断为中耳胆脂瘤患者55 人（63 耳）在术前5 天内进行的16
排HRCT 和1.5T MRI诊断结果，以病理诊断为基础对HRCT 和MRI 的诊断结果进行对比研究，统计分析HRCT 和MRI的灵敏
度、特异度、阳性预期值、阴性预期值，以及Kappa 检验两者之间的内在观察一致性。结果：63 耳中，病理确诊为中耳胆脂瘤40 耳。
HRCT 正确诊断30例，假阳性11例，假阴性10 例，灵敏度、特异度、阳性预期值以及阴性预期值分别为75%、52.17%、73.17%、
54.55%。MRI正确诊断37 例，假阳性和假阴性各为3 例，灵敏度、特异度、阳性预期值以及阴性预期值分别为92.5%、86.96%、75%
和86.96%。HRCT 与MRI诊断结果之间的内在观察一致性Kappa=0.274 (P<0.05)。剔除既往有手术史的10 耳，只针对无手术史
的53 耳，HRCT 与MRI诊断结果之间的内在观察一致性增高，吻合度一般，Kappa=0.462 (P<0.05)。结论：MRI的总体阳性检出率
高于HRCT，尤其是对中耳胆脂瘤手术后复发的诊断；HRCT 与MRI两者相结合对于中耳胆脂瘤的明确诊断具有互补作用。 |
| 英文摘要: |
| Objective:To evaluate and compare the value of high resolution computed tomography (HRCT) and magnetic
resonance imaging (MRI) in the diagnosis of middle ear cholesteatoma.Methods:Retrospectively analyzed 55 patients (63 ears) with
clinically suspected middle ear cholesteatoma who received both 16-slice HRCT and 1.5T MR scanning within 5 days before operation.
HRCT and MRI were compared based on pathology and performed statistical analysis. Sensitivity, specificity, positive predictive value
(PPV), negative predictive value (NPV) of HRCT and MRI were calculated and the inter-observer agreement between both was assessed
with the kappa value.Results:Among 63 ears, 40 ears were diagnosed as middle ear cholesteatoma by pathology. By HRCT, 30 ears
having middle ear cholesteatoma were identified correctly. The false positive was 11 and the false negative was 10. The sensitivity,
specificity, PPV and NPV of HRCT were 75%, 52.17%, 73.17% and 54.55%, respectively. In contrast, 37 ears having middle ear
cholesteatoma were identified correctly by MRI. Both the false positive and the false negative were 3. The sensitivity, specificity, PPV
and NPV of MRI were 92.5%, 86.96%, 75% and 86.96%. The inter-observer agreement between HRCT and MRI was poor, Kappa=0.
274 (P<0.05). Removing 10 post-operative ears, only for the 53 non-operated ears, the inter-observer agreement between HRCT and MRI
raised, Kappa=0.462 (P<0.05).Conclusion:The total positive rate of MRI was higher than HRCT, especially for post-operative
recurrence. The combination of HRCT and MRI had a complementary role in diagnosis of middle ear cholesteatoma. |
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