超声造影在卵巢肿瘤良恶性鉴别诊断中的意义

Value of contrast-enhanced ultrasound in differential diagnosis of benign and malignant ovarian lesions

目的使用造影剂SonoVue分析卵巢病变的超声造影特点,评估其对卵巢良恶性病变的鉴别诊断价值。方法使用常规超声和超声造影观察卵巢病变,分析经手术后病理证实的36例卵巢良恶性病变的超声造影特点。结果 36例卵巢病变患者中良性病变22例,恶性病变14例。22例良性病变中,常规超声检出19例为混合性病变,1例为囊性病变,2例无明显病变;超声造影检出6例为混合性病变,14例为囊性或类囊性病变,2例无明显病变。14例恶性病变中,常规超声检出9例为实性病变,5例为混合性病变;超声造影检出5例为实性病变,9例为混合性病变。时间强度曲线显示良性病变呈缓升缓降型,恶性病变呈速升速降型。与良性病变比较,恶性病变的始增时间、达峰时间、始增强度及峰值强度差异无统计学意义,但增强时间、增强强度及增强速率比较,差异有统计学意义。结论超声造影能准确判断病变的囊实性,分析卵巢良恶性病变的灰阶造影增强方式、时间强度曲线形态及各参数值,能进一步提高鉴别诊断率。

Objective To analyze the characteristic of contrast - enhanced ultrasound （CEUS） with SonoVue, and to evaluate the value of CEUS in differential diagnosis of benign and malignant ovarian lesions. Methods Thirty - six ovarian lesions confirmed by surgery and pathology were observed by conventional ultrasonography and CEUS, then their CEUS characteristics were analyzed. Results In 36 patients with ovarian lesions, there were 22 cases of benign lesions and 14 cases of malignant lesions. In 22 cases of benign lesions, conventional ultrasound detected 19 cases of mixed lesions, 1 case of cystic lesion and 2 cases without obvious lesions, contrast - enhanced ultrasound detected 6 cases of mixed desions, 14 cases of cystic lesions and 2 cases without obvious lesions. While in 14 cases of malignant lesions, conventional ultrasound detected 9 cases of solid lesions and 5 cases of mixed lesions, contrast - enhanced ultrasound detected 5 cases of solid lesions and 9 cases of mixed lesions. The time - intensity curve （TIC） appeared slow - up and slow - down type in benign lesions, and quick - up and quick - down type in malignant lesions. The parameters of TIC demonstrated that there were no significant difference among arrival time, peak time, arrival intensity and peak intensity in malignant and benign lesions, while there was significant difference of enhancement time, enhancement intensity and enhancement velocity in two groups. Conclusion CEUS can estimate the cyst of ovarian lesions exactly, it can improve the diagnosis accurate rate by analyzing the grayscale enhancement mode, time -intensity curve and its various parameters in ovarian malignant and benign tumors.