卵巢肿瘤的三维和二维彩色血管能量成像的临床价值对比研究

Comparison of 2-dimensional and 3-dimensional Color Power Angiography in the Differential Diagnosis of Benign and Malignant Ovarian Tumor

目的比较三维彩色血管能量成像(3D-CPA)和二维彩色血管能量成像(CPA)在鉴别诊断卵巢良恶性肿瘤方面的临床应用价值。方法对53例卵巢肿瘤患者,进行二维彩色血管成像和三维血管立体重建,观察肿物血管的空间分布特点,给出定性诊断,与术后病理结果进行对照分析。结果术后病理证实恶性为32例,良性为21例。CPA的敏感性、特异性、阳性预测值、阴性预测值及符合率分别为93.8%,85.7%,90.9%,90%及90.5%.3D-CPA的敏感性、特异性、阳性预测值、阴性预测值及符合率分别为96.9%,76.2%,86.1%,94.1%及88.7%.3D-CPA和CPA两种检测方法比较差异无统计学意义(χ~2=0.44,P>0.05)。结论在鉴别诊断卵巢肿瘤良恶性方面,3D-CPA的诊断效能与CPA一致。但3D-CPA进一步立体、直观地反映卵巢肿瘤血供,明确地定位病变的位置与范围,对妇科手术方案的制定具有指导意义。

Objective To compare 2-dimensional (2D) and 3-dimensional color power angiography (3 D CPA) in the differential diagnosis of benign and malignant ovarian tumor.Methods Fifty three complex adnexal masses in women were evaluated by 2D and 3D CPA for differentiating benign from malignant masses.All masses were resected surgically to obtain the definitive diagnosis.The sensitivity,specificity, positive predictive value,negative predictive value,and accuracy for the two techniques were calculated.Results Thirty-two tumors were proved to be malignant,and 21 tumors were benign.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy for 2D-CPA were 93.8%,85.7%,90.9%,90% and 90.5% respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy for 3D-CPA were 96.9%o,76.2%,86.1%,94.1% and 88.7% respectively.There were no statistical differences in diagnostic performance of CPA and 3D-CPA (x^2 = 0.44,P > 0.05).Conclusion 3D-CPA did not have a better diagnostic performance than 2D-CPA for the discrimination of benign from malignant complex adnexal masses.