经阴道增强超声造影鉴别诊断附件区良、恶性包块的临床价值

Transvaginal Contrast-enhanced Sonography in the Differentiation of Benign from Malignant Adnexal Masses

目的:探讨超声造影对附件良、恶性包块鉴别诊断的价值。材料和方法:观察分析69例附件区良、恶性包块的超声造影表现及灌注特点。结果:恶性肿瘤26例均有增强显示,其灌注模式主要为快速整体、非均质或树枝状高增强(24/26)。良性肿块39例,其中囊性病灶24例,囊壁增强模式均为环状、半环状增强(5例囊腔内分隔或乳头突起呈轻度增强);实性包块15例,均有增强显示,10例卵巢肿瘤中8例表现为内部点状低增强,5例宫旁浆膜下肌瘤呈先环状增强,后逐渐向内部充填,或呈周边轻度点状增强。良、恶性两组间增强模式存在显著性差异(P<0.0001)。4例卵巢交界性肿瘤呈渐进性或较快速非均质增强。结论:超声造影对鉴别诊断附件区良、恶性包块有较高的价值。

Purpose： The study was designed to investigate the feasibility of contrast-enhanced ultrasound in the differentiation of benign and malignant adnexal masses. Materials and Methods： Sixty-nine consecutive patients with adnexal masses received transvaginal contrast- enhanced ultrasound. The image and perfusion features were assessed. Results： All of 26 malignant tumors showed detectable contrast en- hancement, including 24 cases with a quick, heterogeneous or branching pattern. Among 39 benign lesions, 24 were cystic with circle or half-circle enhancement, including 5 cases with intra-cystic septum or papillae slightly enhanced. The other 15 cases were solid, 8 of them had slightly dotted enhancement. There are significant difference in enhancement patterns between benign and malignant masses （P 〈 0.0001 ）. The 4 cases of borderline tumors showed progressive, heterogeneous enhancement. Conclusion： Contrast-enhanced ultrasound is of value in the differentiation of benign and malignant adnexal masses.