Abstract：
OBJECTIVE: This study aimed to investigate the combined use of ultrasonography and clinical features for the differentiation of malignant peripheral nerve sheath tumors (MPNST) from benign peripheral nerve sheath tumors (BPNST) and to compare the efficacy of ultrasonography with that of magnetic resonance imaging (MRI).
METHODS: This retrospective study included 28 MPNSTs and a control group of 57 BPNSTs. All patients underwent an ultrasound scan using the Logiq E9 (GE Health Care, Milwaukee, WI) or EPIQ7 equipment (Philips Medical System, Bothell, WA). A 3.0-T MRI machine (Ingenia; Philips Healthcare, Best, the Netherlands) was used for scanning, and conventional MRI was performed on different regions based on the patient\'s clinical situation. The following variables were evaluated: palpable mass, pain, nerve symptoms, maximum diameter, location, shape, boundary, encapsulation, echogenicity, echo homogeneity, presence of a cystic component, calcification, target sign, posterior echo, and intertumoral vascularity of the tumors. The diagnostic efficacy of ultrasonography and clinical factors was compared with that of MRI. Independent factors for predicting MPNST versus BPNST were also assessed.
RESULTS: The parameters of location, shape, boundary, encapsulation, and vascularity were significantly different between MPNSTs and BPNSTs. Multiple logistic regression analysis showed that shape, boundary, and vascularity were independent predictors of MPNSTs. The sensitivity, specificity, and Youden index of the three clinical and ultrasound factors (shape, boundary, and vascularity) were 0.89, 0.81, and 0.69, respectively, whereas those of MRI were 0.71, 0.89, and 0.61, respectively. No significant differences in the area under the curve (AUC) of the three combined clinical and ultrasound factors and those of MRI were found (P > .05).
CONCLUSIONS: MRI was useful in the differential diagnosis between MPNSTs and BPNSTs. However, the combination of clinical and ultrasound diagnoses can achieve the same effect as MRI, including shape, boundary, and vasculature.
METHODS: This retrospective study included 28 MPNSTs and a control group of 57 BPNSTs. All patients underwent an ultrasound scan using the Logiq E9 (GE Health Care, Milwaukee, WI) or EPIQ7 equipment (Philips Medical System, Bothell, WA). A 3.0-T MRI machine (Ingenia; Philips Healthcare, Best, the Netherlands) was used for scanning, and conventional MRI was performed on different regions based on the patient\'s clinical situation. The following variables were evaluated: palpable mass, pain, nerve symptoms, maximum diameter, location, shape, boundary, encapsulation, echogenicity, echo homogeneity, presence of a cystic component, calcification, target sign, posterior echo, and intertumoral vascularity of the tumors. The diagnostic efficacy of ultrasonography and clinical factors was compared with that of MRI. Independent factors for predicting MPNST versus BPNST were also assessed.
RESULTS: The parameters of location, shape, boundary, encapsulation, and vascularity were significantly different between MPNSTs and BPNSTs. Multiple logistic regression analysis showed that shape, boundary, and vascularity were independent predictors of MPNSTs. The sensitivity, specificity, and Youden index of the three clinical and ultrasound factors (shape, boundary, and vascularity) were 0.89, 0.81, and 0.69, respectively, whereas those of MRI were 0.71, 0.89, and 0.61, respectively. No significant differences in the area under the curve (AUC) of the three combined clinical and ultrasound factors and those of MRI were found (P > .05).
CONCLUSIONS: MRI was useful in the differential diagnosis between MPNSTs and BPNSTs. However, the combination of clinical and ultrasound diagnoses can achieve the same effect as MRI, including shape, boundary, and vasculature.
摘要：
目的：本研究旨在探讨超声和临床特征联合应用于恶性周围神经鞘瘤（MPNST）和良性周围神经鞘瘤（BPNST）的鉴别诊断，并比较超声和磁共振成像（MRI）的疗效。
方法：这项回顾性研究包括28个MPNST和57个BPNST的对照组。所有患者都使用LogiqE9（GEHealthCare，密尔沃基,WI)或EPIQ7设备(飞利浦医疗系统,Bothell,西澳）。3.0T核磁共振机(Ingenia；飞利浦医疗，最好的,荷兰)用于扫描，根据患者的临床情况，对不同区域进行常规MRI检查。评估了以下变量：可触知的肿块，疼痛,神经症状,最大直径,location,形状,边界,封装，回声,回声均匀性，存在囊性成分，钙化,目标标志,后回声,和肿瘤的肿瘤间血管。比较超声与临床因素的诊断效能。还评估了预测MPNST与BPNST的独立因素。
结果：位置参数，形状,边界,封装，MPNST和BPNST之间的血管分布显着不同。多因素logistic回归分析表明,边界,血管分布是MPNSTs的独立预测因子。敏感性,特异性，和尤登指数的三个临床和超声因素(形状，边界,和血管分布)分别为0.89、0.81和0.69，而MRI分别为0.71、0.89和0.61。三种临床和超声综合因素的曲线下面积（AUC）与MRI无明显差异（P>0.05）。
结论：MRI对MPNSTs和BPNSTs的鉴别诊断有用。然而,结合临床和超声诊断可以达到与MRI相同的效果，包括形状,边界,和脉管系统。
方法：这项回顾性研究包括28个MPNST和57个BPNST的对照组。所有患者都使用LogiqE9（GEHealthCare，密尔沃基,WI)或EPIQ7设备(飞利浦医疗系统,Bothell,西澳）。3.0T核磁共振机(Ingenia；飞利浦医疗，最好的,荷兰)用于扫描，根据患者的临床情况，对不同区域进行常规MRI检查。评估了以下变量：可触知的肿块，疼痛,神经症状,最大直径,location,形状,边界,封装，回声,回声均匀性，存在囊性成分，钙化,目标标志,后回声,和肿瘤的肿瘤间血管。比较超声与临床因素的诊断效能。还评估了预测MPNST与BPNST的独立因素。
结果：位置参数，形状,边界,封装，MPNST和BPNST之间的血管分布显着不同。多因素logistic回归分析表明,边界,血管分布是MPNSTs的独立预测因子。敏感性,特异性，和尤登指数的三个临床和超声因素(形状，边界,和血管分布)分别为0.89、0.81和0.69，而MRI分别为0.71、0.89和0.61。三种临床和超声综合因素的曲线下面积（AUC）与MRI无明显差异（P>0.05）。
结论：MRI对MPNSTs和BPNSTs的鉴别诊断有用。然而,结合临床和超声诊断可以达到与MRI相同的效果，包括形状,边界,和脉管系统。
