阴道超声结合CDFI诊断卵巢肿瘤的价值

Value of transvaginal ultrasonography and CDFI in the diagnosis of ovarian tumors

目的探讨经阴道超声结合彩色普勒超声鉴别附件肿瘤良恶性的价值。方法对84例附件肿瘤患者进行术前阴道超声检查,对声像图行形态学特征分析及Lerner评分;同时用彩色多普勒检测获得PI值和RI值,将诊断结果与手术病理相对照。结果以B超积分≥3分诊断卵巢恶性肿瘤的符合率为90.3%,以B超积分<3分诊断卵巢良性肿瘤的符合率为92.5%,良恶性肿瘤Lerner评分差异有统计学意义(P<0.01)。良性肿瘤血管多分布于肿瘤周边或隔上,而恶性肿瘤血供丰富,血管主要分布于肿瘤实质区。良恶性肿瘤RI、PI值差异有统计学意义(P<0.01)。以B超积分≥3分和PI<1.0、RI<0.4诊断卵巢恶性肿瘤的符合率为96.8%,以B超积分<3分和PI≥1.0、RI≥0.4诊断卵巢良性肿瘤的符合率为96.2%。结论不能单纯用PI或RI等某一指标来判断肿瘤的性质,联合应用二维超声、CDFI及动力学指标,综合分析,可最大限度地提高对附件肿瘤诊断的准确性。

Objective To investigate the diagnostic value of transvaginal ultrasonography and color Dop-plor ultrasonography for benign and malignant ovarian tumors.Methods 884 patients with adnexal masses were ex-amined with transvaginal ultrasonography before operation.Morphologic evaluation was performed and the total ul-trasound score was calculated according to Lerner scoring system,and by color Doppler ultrasonography to analyzed PI and RI of peripheral blood flow of mass.Results Mass Scoring≥3,90.3%masses were malignant tumors;Mass Scoring3,92.5%masses were benign tumors.The difference of ultrasound score between benign and malignant masses was significant（P0.01）.Mass Scoring PI1.0,RI0.4 as standard for malignancy,the sensitivity,specificity and accuracy rate were 83.9%,88.7%,86.9%respectively.In benign tumors,no flow was seen or most flow signals distributed peripherally or septally.In malignant tumors,the vessels distributed in the tumor centers and mainly be-longed.The RI and PI difference between benign and malignant masses was significan（tP0.01）.Mass Scoring≥3 and PI1.0,RI0.4 as standard for malignancy,diagnosis match rate was 96.8%,Mass Scoring3 and PI≥1.0,RI≥0.4 as standard for benign,diagnosis match rate was 96.2%.Conclusion Based on 2-D ultrasound for morphol-ogy,synthetic analysis of blood distribution and dynamics may elevate diagnostic accuracy for ovarian tumors maximally.