MRI预测模型用于弥漫型腱鞘巨细胞瘤的风险评估

MRI Prediction Model for Tenosynovial Giant Cell Tumor with Risk of Diffuse-type

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ACADEMIC RADIOLOGY

影响因子:3.9

分区:医学2区 / 核医学2区

发表日期:2023 Nov

作者: Jun-Ho Kim, Seul Ki Lee, Jee-Young Kim

DOI: 10.1016/j.acra.2023.01.012

摘要

旨在提出一种用于弥漫型腱鞘巨细胞瘤（D-TSGCT）MRI预测模型。首先对解剖位置进行分类，然后评估MRI上的结节性、边缘、外围和内部低信号以及骨和软骨的受累情况。采用学生t检验、卡方检验、诊断性能分析、逻辑回归分析和决策树分析。共纳入19例关节内（其中11例局限型，8例弥漫型）和55例关节外（其中44例局限型，11例弥漫型）TSGCT。结果显示，关节外弥漫型D-TSGCT在多结节（72.7%对25.0%，p=0.009）和侵袭性病变（90.9%对34.1%，p=0.002）方面显著更常见，没有外围低信号（90.9%对18.2%，p<0.001），且具有颗粒状内部低信号（72.7%对31.8%；p=0.003），伴随骨（81.8%对27.3%，p=0.003）和软骨（50.0%对0.0%，p=0.038）受累。关节内弥漫型D-TSGCT在所有MRI特征上也表现出显著差异（100.0%对9.1%，p=0.001；100.0%对27.3%，p=0.007；100.0%对36.4%，p=0.018；100.0%对27.3%，p=0.007；50.0%对0.0%，p=0.038），除了骨受累（37.5%对9.1%，p=0.352）无显著差异。软骨受累具有最高的特异性（88.6-100.0%），结节性（100.0%；比值比[OR]：70.000）和外围低信号（90.9%；OR：62.250）在关节内和关节外病例中分别表现出最高的敏感性。基于软骨受累、结节性和外围低信号的MRI模型，分别在两个解剖位置上表现出100%敏感性和90.9特异性（关节内）以及100%敏感性和77.2%的特异性（关节外），为D-TSGCT的风险评估提供了有效的影像学依据。

Abstract

To propose a magnetic resonance imaging (MRI) prediction model for diffuse-type tenosynovial giant cell tumors (D-TSGCTs).Anatomic locations were classified and then nodularity, margin, peripheral and internal hypointensity, and bone and cartilage involvement were evaluated on MRI. Student's t-test, chi-square test, diagnostic performance, logistic regression analysis, and decision tree were performed.Nineteen intra-articular (11 localized; eight diffuse) and 55 extra-articular (44 localized; 11 diffuse) TSGCTs were included. Extra-articular D-TSGCTs showed significantly more frequent multinodular (72.7% vs. 25.0%, p = 0.009), and infiltrative lesions (90.9% vs. 34.1%, p = 0.002), without peripheral hypointensity (90.9% vs. 18.2%, p < 0.001), and contained granular internal hypointensity (72.7% vs. 31.8%; p = 0.003) with more frequent bone (81.8% vs. 27.3%; p = 0.003) and cartilage (50.0% vs. 0.0%; p = 0.038) involvement than localized-type. Intra-articular D-TSGCT also showed significance in all MRI features (100.0% vs. 9.1%, p = 0.001; 100.0% vs. 27.3%, p = 0.007; 100.0% vs. 36.4%, p = 0.018; 100.0% vs. 27.3%, p = 0.007; 50.0% vs. 0.0%, p = 0.038), except bone involvement (37.5% vs. 9.1%, p = 0.352) than localized-type. Cartilage involvement revealed the highest specificity (88.6-100.0%), regardless of location. Nodularity (100.0%; odds-ratio [OR]: 70.000) and peripheral hypointensity (90.9%; OR: 62.250) demonstrated the highest sensitivities ORs for D-TSGCT in intra-articular and extra-articular cases, respectively. MRI models for D-TSGCG beginning with the cartilage involvement in both anatomic locations and next on nodularity and peripheral hypointensity in intra-articular and extra-articular locations, respectively, exhibited sensitivity and specificity of 100% and 90.9% for intra-articular and 100% and 77.2% for extra-articular TSGCTs, respectively.MRI can suggest the risk of D-TSGCT by combining imaging features with anatomic locations.