阴道彩色多普勒超声对卵巢囊肿蒂扭转的诊断价值

Diagnostic value of transvaginal color Doppler ultrasound in torsion of ovarian cyst pedicle

目的探讨阴道彩色多普勒超声对卵巢囊肿蒂扭转的诊断价值。方法选取2017年8月至2019年7月在黄河水利委员会黄河中心医院治疗的68例卵巢囊肿蒂扭转患者,所有患者均分别进行腹部超声、阴道彩色多普勒超声检查,以病理诊断结果为金标准,比较两组彩色多普勒超声检查结果、手术结果。结果经过腹部彩色多普勒超声、阴道彩色多普勒超声检查,均能够发现大小不一的囊性、囊实性包块,大小为2 cm×3 cm^14 cm×22 cm。阴道超声检查显示,包块边界清晰,囊壁厚度不一,部分患者回声明显,囊内可见隔光带;部分患者囊内可见团块状、斑点状、浮点状回声;血管超声图像显示,扭转蒂为旋涡状、斑点状、麻花状;大部分肿块均与腹部无粘连,移动性较好。未探及扭转蒂血流信号36例,可探及动脉频谱21例,可探及动静脉频谱11例。经腹部彩色多普勒超声图像显示,有单纯实性、无回声肿块、混合型回声肿块,直径≥50 mm,内部透射度数较差,多位于中腹部、下腹部,大部分可见盆腔游离型暗区。经腹部彩色多普勒超声诊断符合率为67.65%(46/68),阴道彩色多普勒超声为92.65%(63/68),差异有统计学意义(χ~2=13.36,P<0.05)。结论对卵巢囊肿蒂扭转采取阴道彩色多普勒超声检查的诊断符合率更高,尤其适合偏小或中度蒂扭转病灶,是一种可靠的辅助诊断方式。

Objective To investigate the value of transvaginal color Doppler ultrasound in the diagnosis of torsion of ovarian cyst pedicle.Methods From August 2017 to July 2019,68 patients with torsion of ovarian cyst pedicle who were treated in Yellow River Central Hospital of Yellow River Water Conservancy Commission were selected.All patients were examined by abdominal ultrasound and vaginal color Doppler ultrasound respectively.The results of color Doppler ultrasound and operation of the two groups were compared according to the gold standard of pathological diagnosis.Results Through the examination of abdominal color Doppler ultrasound and vagina color Doppler ultrasound,we can find cystic and solid masses of different sizes,ranging from 2 cm×3 cm to 14 cm×22 cm.Transvaginal ultrasound showed that the boundary of the mass was clear,the thickness of the wall of the capsule was different,the echo of some patients was obvious,and the light barrier was visible in the capsule;the mass,spot and floating-point echo were visible in the capsule of some patients;the vascular ultrasound image showed that the torsion pedicle was vortex,spot and twist;most of the masses had no adhesion with the abdomen and had good mobility.There were 36 cases of blood flow signal without torsion pedicle,21 cases of arterial spectrum and 11 cases of arteriovenous spectrum.According to the color Doppler ultrasound images of abdomen,there are simple solid,non echoic and mixed echoic masses with a diameter of≥50 mm,poor internal transmission,mostly in the middle and lower abdomen,and most of them can be seen in the free dark area of pelvis.The diagnostic accuracy of transabdominal CDUS was 67.65%(46/68),and that of vaginal CDUS was 92.65%(63/68).The difference was significant(χ~2=13.36,P<0.05).Conclusions The diagnostic accuracy of transvaginal color Doppler ultrasound is higher for torsion of ovarian cyst pedicle,especially for small or moderate torsion lesions,which is a reliable auxiliary diagnostic method.