超声造影在附件区肿块良恶性鉴别诊断中的应用

Application of CEUS in the Differential Diagnosis of Mass in the Adnexal Area

目的:评价超声造影(CEUS)在常规超声(US)不能鉴别诊断的附件区良恶性包块中的应用价值。方法:2010年8月30日至2011年1月31日间,对US未能显示出病灶特征,良恶性鉴别诊断困难的附件区包块24例患者再行CEUSc。回顾性分析其临床病理资料。结果:19例经穿刺或/和外科手术病检证实、5例经临床诊断(诊断性治疗、复查和随访)证实:卵巢恶性肿瘤13例、良性包块11例(良性肿瘤9例、附件炎性包块2例)。CEUS诊断13例恶性肿瘤准确率100%,敏感性100%(13/13);诊断良性包块9例正确,2例误诊(粘液性囊腺瘤诊断为粘液性囊腺癌),特异性82%(9/11);CEUS鉴别附件区良、恶性包块的准确性为92%(22/24)。结论:CEUS可敏感显示US不能鉴别诊断的附件区良、恶性包块的病变特征,有助于良/恶性质的诊断与鉴别诊断。

Objective： To evaluate CEUS （contrast-enhanced ultrasonography ） in the differential diagnosis of benign and ma- lignant adnexal mass comparing with the conventional ultrasound （US）. Methods： From August 30, 2010 to January 31,2011, 24 cases of patients with adnexal mass which were failed to be identified by the US of the benign and malignant character accepted the CEUS. Clinical and pathological features were retrospectively analyzed. Results： Diagnosis of 19 patients were confirmed by biopsy and / or surgery and pathology examination while 5 cases were identified by clinical diagnosis （conservative treatment, review and following-up ）. They were 13 cases of ovarian cancer, 11 cases of benign masses （ 9 cases of tnmour, 2 cases of inflammatory adnexal mass ）. The accuracy rate of CEUS to diagnose 13 cases of malignant tumors was 100% with sensitivity of 100% （13/13）. As for the benign mass, 9 cases got the right conclusion with 2 cases were misdiagnosed（ mucinous cystadenoma were diagnosed as cancer）. The specificity was 82% （9/11）. The accuracy rate of CEUS to identify the benign and malignant adnexal mass was 92% （22/24）. Conclusion ： CEUS is sensitive to the show the characteristics of benign and malignant adnexal mass which can not be identified by US. It is helpful for the diagnosis and differential diagnosis of benign/malignant nature of adnexal mass.