摘要
目的探讨超声鉴别肢体法瓦病与静脉畸形(VMs)的辅助诊断价值。方法以2015年1月至2020年12月河南省人民医院手术病理确诊的下肢法瓦病患者作为法瓦病组,选取经病理确诊的下肢VMs患者作为对照组,对其临床和超声影像学资料进行回顾性分析。通过对两组资料的单因素分析,筛选对鉴别法瓦病和VMs可能有价值的超声影像学指标,进一步采用多因素Logistic回归分析确定有鉴别诊断价值的指标,并构建多因素联合诊断模型,采用受试者操作特征曲线(ROC曲线)、敏感度和特异度等指标评价联合诊断模型的诊断效能。结果纳入法瓦病患者20例,男11例,女9例,年龄(18.1±12.2)岁;VMs患者46例,男20例,女26例,年龄(19.9±13.6)岁。单因素分析结果显示,法瓦病组与VMs组的超声表现在病灶回声、"筋膜尾"征、血流、挤压试验阳性、后方回声增强方面差异均有统计学意义(P<0.05)。多因素分析显示,两组的超声表现在"筋膜尾"征、挤压试验阳性、后方回声增强3方面差异统计学意义(P=0.001、0.008、0.007),所构建的包括该3项指标的联合诊断模型诊断法瓦病的敏感度为90.0%(95%CI:68.3%~98.8%),特异度为93.5%(95%CI:82.1%~98.6%),ROC曲线下面积为0.964(95%CI:0.886~0.994),具有较高的诊断效能。结论法瓦病与VMs超声影像学特征有明显区别。超声检查中的"筋膜尾"征、挤压试验阳性、后方回声增强3个指标联合较单一指标对诊断法瓦病有更高的辅助诊断价值。
Objective To investigate the differential performance of ultrasound between fibro-adipose vascular anomaly(FAVA)and venous malformations(VMs).Methods From January 2015 to December 2020,the patients diagnosed with lower extremity FAVA by pathology in Henan Provincial People’s Hospital were enrolled as FAVA group.The patients diagnosed with lower extremity VMs by pathology were enrolled as the control group.The clinical and ultrasound imaging data were retrospectively analyzed.Through the single factor analysis of the two groups’data,the ultrasonic imaging indicators which may be valuable for distinguishing FAVA from VMs were screened.Further,the indicators valuable for differential diagnosis were determined by multi-factor Logistic regression analysis,and a multi-factor joint diagnosis model was constructed.The diagnostic efficiency of the joint diagnosis model was evaluated by the receiver operator characteristic curve(ROC curve),sensitivity,and specificity of the subjects.Results A total of 20 patients with FAVA were involved,including 11 males and 9 females.The mean age was(18.1±12.2)years.Forty-six patients with VMs were involved,including 20 males and 26 females.The mean age was(19.9±13.6)years.Results of the single-factor analysis were differences in the lesion echo,fascial tail,blood flow,extrusion test,and posterior echo enhance characteristics between groups(P<0.05).Multivariate analysis showed significant differences between groups in three aspects:fascial tail,extrusion test,and posterior echo enhancement(P=0.001,0.008,0.007).The sensitivity and specificity of the multi-factor combined diagnosis model were 90.0%(95%CI:68.3%-98.8%)and 93.5%(95%CI:82.1%-98.6%),indicating high diagnostic efficiency.The ROC(AUC)area was 0.964(95%CI:0.886-0.994),indicating high diagnostic efficiency.Conclusions The ultrasonic imaging features of FAVA and VMs were different.The combined diagnosis of the fascial tail,compression test,and posterior echo enhancement has a higher auxiliary diagnostic value.
作者
胡文笳
刘昱晗
董长宪
龚毓宾
赵晓娟
吴刚
魏帆
范盼红
Hu Wenjia;Liu Yuhan;Dong Changxian;Gong Yubin;Zhao Xiaojuan;Wu Gang;Wei Fan;Fan Panhong(Department of Ultrasound,Henan Provincial People’s Hospital,Zhengzhou 450003,China)
出处
《中华整形外科杂志》
CSCD
2022年第3期259-264,共6页
Chinese Journal of Plastic Surgery
关键词
动静脉畸形
超声检查
法瓦病
Arteriovenous malformations
Ultrasonography
Fibro-adipose vascular anomaly
