METHODS: An observational chart review study of patients with retinoblastoma that had histopathology of the lesion and orbit magnetic resonance imaging with apparent diffusion coefficient analysis at Hospital de Clínicas de Porto Alegre between November 2013 and November 2016 was performed. The histopathology was reviewed after enucleation. To analyze the difference in apparent diffusion coefficient values between the two major histopathological prognostic groups, Student\'s t-test was used for the two groups. All statistical analyses were performed using SPSS version 19.0 for Microsoft Windows (SPSS, Inc., Chicago, IL, USA). Our institutional review board approved this retrospective study without obtaining informed consent.
RESULTS: Thirteen children were evaluated, and only eight underwent eye enucleation and were included in the analysis. The others were treated with photocoagulation, embolization, radiotherapy, and chemotherapy and were excluded due to the lack of histopathological results. When compared with histopathology, magnetic resonance imaging demonstrated 100% accuracy in retinoblastoma diagnosis. Optic nerve invasion detection on magnetic resonance imaging showed a 66.6% sensitivity and 80.0% specificity. Positive and negative predictive values were 66.6% and 80.0%, respectively, with an accuracy of 75%. In addition, the mean apparent diffusion coefficient of the eight eyes was 0.615 × 103 mm2/s. The mean apparent diffusion coefficient value of poorly or undifferentiated retinoblastoma and differentiated tumors were 0.520 × 103 mm2/s and 0.774 × 103 mm2/s, respectively.
CONCLUSIONS: This study revealed that magnetic resonance imaging is useful in the diagnosis of retinoblastoma and detection of optic nerve infiltration, with a sensitivity of 66.6% and specificity of 80%. Our results also showed lower apparent diffusion coefficient values in poorly differentiated retinoblastomas with a mean of 0.520 × 103 mm2/s, whereas in well and moderately differentiated, the mean was 0.774 × 103 mm2/s.
方法:对2013年11月至2016年11月在阿雷格里港Clínicas医院接受病变组织病理学和眼眶磁共振成像及表观扩散系数分析的视网膜母细胞瘤患者进行了观察性图表回顾研究。摘除后进行组织病理学检查。分析两个主要组织病理学预后组之间的表观扩散系数值的差异,两组采用学生t检验。所有统计分析均使用适用于MicrosoftWindows的SPSS19.0版(SPSS,Inc.,芝加哥,IL,美国)。我们的机构审查委员会在未获得知情同意的情况下批准了这项回顾性研究。
结果:对13名儿童进行了评估,只有8人接受了眼球摘除术,并被纳入分析.其他人接受了光凝治疗,栓塞,放射治疗,和化疗,由于缺乏组织病理学结果而被排除。与组织病理学相比,磁共振成像在视网膜母细胞瘤诊断中显示出100%的准确性。磁共振成像检测视神经侵犯的敏感性为66.6%,特异性为80.0%。阳性预测值和阴性预测值分别为66.6%和80.0%,分别,准确率为75%。此外,8只眼的平均表观扩散系数为0.615×103mm2/s。低分化或未分化视网膜母细胞瘤和分化肿瘤的平均表观扩散系数值分别为0.520×103mm2/s和0.774×103mm2/s,分别。
结论:这项研究表明,磁共振成像对视网膜母细胞瘤的诊断和视神经浸润的检测是有用的。敏感性为66.6%,特异性为80%。我们的结果还显示低分化视网膜母细胞瘤的表观扩散系数值较低,平均值为0.520×103mm2/s,而在分化良好和中等程度的情况下,平均值为0.774×103mm2/s。