经阴道彩色多普勒超声诊断上皮性卵巢癌准确性探讨

Evaluation of accuracy of parameters of transvaginal color Doppler ultrasonography in diagnosing epithelial ovarian cancer

目的 探讨经阴道彩色多普勒超声 (TVCDU )检测卵巢肿瘤血流指标诊断卵巢癌的准确性。方法 测定 60例上皮性卵巢癌 (EOC)及 3 6例良性卵巢上皮性肿瘤的TVCDU各血流参数 ,并应用免疫组化方法检测术后卵巢肿瘤内的微血管密度 (MVD) ,比较EOC组与良性组之间各参数的差异 ,分析TVCDU各参数与MVD的相关性。结果 ①EOC组与良性组的动脉显示率、动脉数目、血管分布类型、搏动指数(PI)、阻力指数 (RI)、收缩期与舒张末期血流速度比值 (S/D)、时间平均最大流速 (TAMXV)差异有非常显著性意义 (P <0 .0 0 1) ,动脉频谱有无舒张期切迹差异有显著性意义 (P <0 .0 5 ) ,收缩期峰值速度 (PSV)的差异无统计学意义 (P =0 .193 )。②EOC组与良性组之间MVD差异有显著性意义 (P <0 .0 0 1)。EOC组MVD与PI、RI、S/D呈负相关 ,与PSV、TAMXV无明显相关性。结论 TVCDU诊断EOC时 ,血管分布类型、动脉数目及PI、RI。

Objective To evaluate which parameters of transvaginal color Doppler ultrasonography(TVCDU) can effectively reflect blood flow in ovarian tumors. Methods TVCDU was preoperatively used to determine all the parameters of blood flow in 60 women with epithelial ovarian cancer(EOC) and 36 with benign ovarian cystadenomas (control group). Microvessel density(MVD) was tested in the tissue samples by immunohistochemical method(SP method). The parameters of TVCDU in EOC were compared with those in control group.The correlation between MVD and the parameters in EOC group and control group was analyzed. Results ①Statistical differences of arteria showing rate, arteria number, vasculature type, diastolic notch, PI, RI, S/D, TAMXV were seen between EOC group and control group(P<(0.001),except for the P of diastolic notch smaller than (0.05)). ②Statistical differences of MVD were shown between EOC group and control group(P<(0.001)). There were significant negative correlations between MVD and PI, RI, S/D in EOC, but no obvious correlations between MVD and PSV, TAMXV. Conclusions Vasculature type, arteria number and PI,RI,S/D are more meaningful than other parameters to reflect blood flow on diagnosing EOC by TVCDU.