多排螺旋CT在鉴别卵巢与非卵巢肿瘤中的应用价值

Value of multidetector computed tomography in differentiating ovarian tumors from non-ovarian masses

目的探讨多排螺旋CT(MDCT)对卵巢源性与非卵巢源性肿瘤的鉴别诊断价值。方法42例盆腔肿块患者术前行16排螺旋CT扫描,并行多平面重组(MPR)和曲面重组(CPR)。以术后病理诊断为标准,评价卵巢血管蒂征、病侧正常卵巢显示、盆腔肿块与输尿管的关系在卵巢源性与非卵巢源性肿瘤鉴别诊断中的价值。结果42例盆腔肿块中,术后病理诊断卵巢源性肿瘤28例,非卵巢源性肿瘤14例。以卵巢血管蒂征判断卵巢源性肿瘤的准确率为88.1%,敏感性为89.3%,特异性为85.7%,阳性预测值为92.6%,阴性预测值为80.0%。CPR可清楚显示卵巢血管蒂与盆腔肿块的关系。以病侧正常卵巢显示判断非卵巢源性肿瘤的准确率为83.3%,敏感性为50.0%,特异性为100.0%,阳性预测值为100.0%,阴性预测值为80.0%。卵巢血管蒂征及病侧正常卵巢是否存在对鉴别卵巢源性与非卵巢源性肿瘤均有统计学意义(P<0.01)。结论MDCT能清楚显示盆腔肿瘤与卵巢及卵巢血管蒂的关系,对鉴别卵巢源性与非卵巢源性肿瘤有重要价值。

Objective To evaluate the ability of muhidetector computed tomography （MDCT） in differentiating ovarian tumors from non-ovarian masses. Methods Forty-two cases with pelvic masses were examined with 16-row MDCT. All source image of each case was put into workstation for multi-planar reconstruction （MPR） and curved planar reconstruction（CPR）. Axial image combined with 2D image was used for determining the relationship of the mass to ovarian vascular pedicle and identifying the normal ovary, which was compared with postoperative pathologic result and the finding during operation. All the data was compared using Fisher＇s exact test. Results There were 28 ovarian tumors and 14 non-ovarian tumors in this series. If the ovarian vascular pedicle sign was used for determining whether the tumor was from the ovary or not, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 89.3%, 85.7%, 92.6%, 80.0% and 88. 1%, respectively, with a significant difference in differentiating the tumor from the ovary or non-ovarian organs （ P 〈 0.05 ）. If the identification of full normal ovary was used to determine non-ovarian origin of the tumor, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 50.0%, 100.0%, 100.0%, 80.0% and 83.3%, respectively, also with a significant difference in differentiating the tumors from the ovary or non-ovarian organs （ P 〈 0.05 ）. Conduslou MDCT can clearly show the relationship of the tumor to the normal ovary and its vascular pedicle, which is very helpful in differentiating the ovarian tumors from a non-ovarian masses.