Objective: The ultrasonography features of alveolar soft part sarcoma (ASPS) and intramuscular capillary-type hemangiomas (ICTH) were analyzed, and the diagnostic model of ASPS was established. Methods: A cross-sectional study was carried out. The clinical data of 52 patients [28 males and 24 females, aged (20.7±15.1) years] with pathologically confirmed ASPS and ICTH admitted to People's Hospital of Henan Province from January 2005 to February 2023 were included in the study. According to pathological types, the patients were divided into ASPS group and ICTH group. Clinical data of patients were retrospectively collected, and meaningful indicators in the univariate analysis were included in the regression analysis for screening. After comprehensive consideration of clinical significance and statistical significance, eligible indicators were selected for inclusion in the regression analysis. Binary logistic regression analysis was used to screen the factors that distinguished the pathological types of ASPS and ICTH, and the diagnostic model was established. The area under receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic effectiveness of the diagnostic model in distinguishing ASPS from ICTH. Results: There were 20 patients in ASPS group, 10 males and 10 females, aged (26.9±13.5) years, and 32 patients in ICTH group, 18 males and 14 females, aged (16.8±15.0) years. The age difference between the ASPS group and the ICTH group was statistically significant (P<0.05), and there were statistically significant differences in the ultrasound imaging features of "clear boundary" "peripheral lobe" "thin blood vessels inside the lesion are straight and out of shape" "intra-lesion liquification" "peripheral thick blood vessels" and "peripheral muscle fiber disruption" between the two groups (all P<0.001).Variables with clinical and statistical significance were selected as independent variables. Binary logistic regression analysis showed that peripheral muscle fiber interruption (OR=97.358, 95%CI:6.833-1 387.249) and internal thin blood vessels were flat and out of shape (OR=0.052, 95%CI:0.003-0.921) was the correlation factor to distinguish the pathological types of ASPS and ICTH. Two ultrasonic image features of "peripheral muscle fiber interruption" and "internal thin blood vessels are straight and out of shape" were used to establish the diagnostic model. The sensitivity of "peripheral muscle fiber interruption" diagnostic model was 81.3%, and the specificity was 95.0%. The AUC was 0.811(95%CI: 0.761-0.954). The sensitivity, specificity and AUC of the diagnosis model of "internal thin vessels with flat misshape" were 90.0%, 96.9% and 0.934(95%CI: 0.830-0.984). The sensitivity, specificity and AUC of the combined diagnosis model of "peripheral muscle fiber interruption" and "internal thin blood vessel straight out of shape" were 96.9%, 90.0% and 0.974(95%CI:0.877-0.999). Conclusion: Ultrasonography can be used to distinguish ASPS from ICTH, and the combined diagnostic model based on the two ultrasonic imaging features of "peripheral muscle fiber interruption" and "internal thin blood vessel straight out of shape" can further improve the diagnostic efficiency.
目的： 分析超声中腺泡状软组织肉瘤（ASPS）与肌内毛细血管瘤（ICTH）的影像学特征，构建诊断模型。 方法： 横断面研究。将2005年1月至2023年2月河南省人民医院收治的52例经病理证实的ASPS和ICTH患者纳入研究，其中男28例，女24例，年龄（20.7±15.1）岁。根据病灶病理类型分为ASPS组和ICTH组。回顾性收集患者的临床资料，将单因素分析中有意义的指标纳入回归分析中进行筛选，综合考虑临床意义和统计学意义，选取符合条件的指标纳入回归分析。采用二元logistic回归分析来筛选区分ASPS及ICTH病理类型的因素，建立诊断模型。采用受试者工作特征（ROC）曲线下面积（AUC）评估诊断模型鉴别ASPS和ICTH的效能。 结果： ASPS组患者20例，男10例，女10例，年龄（26.9±13.5）岁；ICTH组患者32例，男18例，女14例，年龄（16.8±15.0）岁。ASPS组与ICTH组患者年龄差异有统计学意义（P<0.05），两组超声影像学特征中“边界清楚”“病灶周边分叶”“病灶内部纤细血管平直走形”“病灶内液化”“周边粗大血管”和“周边肌纤维中断”方面差异均有统计学意义（均P<0.001）。选取具有临床意义和统计学意义的变量作为自变量，二元logistic回归分析显示，周边肌纤维中断（OR=97.358，95%CI：6.833~1 387.249）和内部纤细血管平直走形（OR=0.052，95%CI：0.003~0.921）是区分ASPS及ICTH病理类型的相关因素，采用“周边肌纤维中断”和“内部纤细血管平直走形”两个超声影像特征建立诊断模型，“周边肌纤维中断”诊断模型灵敏度为81.3%，特异度为95.0%，AUC为0.811（95%CI：0.761~0.954）；“内部纤细血管平直走形”诊断模型灵敏度为90.0%，特异度为96.9%，AUC为0.934（95%CI：0.830~0.984）；“周边肌纤维中断”和“内部纤细血管平直走形”联合诊断模型灵敏度为96.9%，特异度为90.0%，AUC为0.974（95%CI：0.877~0.999）。 结论： 超声检查可用于鉴别ASPS与ICTH，采用“周边肌纤维中断”和“内部纤细血管平直走形”两个超声影像学特征建立的联合诊断模型可进一步提高诊断效能。.