| 赵一冰,陈涛.超声鉴别诊断儿童四肢长骨嗜酸性肉芽肿与骨髓炎[J].中国医学影像技术,2022,38(5):743~746 |
| 超声鉴别诊断儿童四肢长骨嗜酸性肉芽肿与骨髓炎 |
| Ultrasonic differential diagnosis of children extremity long bone eosinophilic granuloma and osteomyelitis |
| 投稿时间：2021-08-01 修订日期：2021-11-17 |
| DOI：10.13929/j.issn.1003-3289.2022.05.026 |
| 中文关键词: 组织细胞增生症,朗格汉斯细胞 骨髓炎 长骨 超声检查 |
| 英文关键词:histiocytosis, Langerhans-cell osteomyelitis long bone ultrasonography |
| 基金项目:北京积水潭医院院级科研基金(2019-YJ05)。 |
|
| 摘要点击次数: 1475 |
| 全文下载次数: 549 |
| 中文摘要: |
| 目的 评价超声鉴别诊断儿童四肢长骨嗜酸性肉芽肿(EGB)与骨髓炎的价值。方法 纳入经病理证实的EGB(EGB组)和骨髓炎(骨髓炎组)患儿各37例,观察组间超声表现差异。采用二元logistic回归分析,根据超声表现建立联合鉴别诊断方程;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价各超声表现及联合诊断方程鉴别EGB与骨髓炎的效能。结果 EGB组与骨髓炎组病灶周围软组织改变差异无统计学意义(P＞0.05);组间骨质破坏伴回声、骨膜反应及病灶血流信号表现差异均有统计学意义(P均＜0.05)。二元logistic回归联合诊断方程为:Y=－1.061×骨质破坏伴回声＋2.371×骨膜反应＋1.995×病灶血流丰富。以骨质破坏伴回声、骨膜反应及病灶血流丰富鉴别EGB与骨髓炎的AUC分别为0.518、0.702及0.689;以联合诊断方程进行鉴别的AUC为0.766,高于单一超声表现(P均＜0.05),截断值为0.568时,鉴别诊断敏感度为97.31%,特异度为59.54%。结论 超声可鉴别儿童四肢长骨EGB与骨髓炎;联合应用各超声表现可提高鉴别诊断效能。 |
| 英文摘要: |
| Objective To observe the value of ultrasonography in differential diagnosis of eosinophilic granuloma (EGB) and osteomyelitis of extremity long bone in children.Methods Totally 37 children with EGB (EGB group) and 37 children osteomyelitis (osteomyelitis group) proved by pathology were enrolled, and the ultrasonographic manifestations were analyzed and compared between groups. Binary logistic regression analysis was used to screen ultrasonic findings and establish a combined differential diagnosis equation. The receiver operating characteristic (ROC) curves were drawn, and the areas under the curves (AUC) were calculated to evaluate the diagnostic efficiency of ultrasonic performances and combined differential diagnosis equation for differentiating EGB and osteomyelitis.Results There was no significant difference of soft tissue changes around lesions (P＞0.05), while significant differences of bone destruction with echo, periosteal reaction and blood flow signals of lesions were detected between groups (all P＜0.05). The combined differential diagnosis equation of binary logistic regression was as Y=－1.061×bone destruction with echo+2.371×periosteal reaction+1.995×rich blood flow in the lesion. The AUC of distinguishing EGB and osteomyelitis according to bone destruction with echo, periosteal reaction and rich blood flow in the lesion was 0.518, 0.702 and 0.689, respectively, of the combined equation was 0.766, higher than that of every single manifestation (all P＜0.05). Taken 0.568 as the cut-off value, the sensitivity of the combined equation for differential diagnosis of EGB and osteomyelitis was 97.31%, and the specificity was 59.54%.Conclusion Ultrasound could be used to distinguish EGB and osteomyelitis in extremity long bone of children. Combining of ultrasonic findings could improve the efficiency of differential diagnosis. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
