经腹彩色多普勒显像对诊断卵巢恶性肿瘤的价值

Value of transabdominal color Doppler ultrasonography in the diagnosis of malignant ovarian tumors

目的 探讨经腹彩色多普勒超声观察血管定位和血流曲线形态对诊断卵巢恶性肿瘤的价值。方法 使用彩色多普勒超声检查 2 8例卵巢恶性肿瘤和 41例良性肿瘤 ,测定肿瘤的血管定位、舒张期切迹、搏动指数(PI)和阻力指数 (RI) ,将PI和RI与术后病理组织学结果对照 ,以此预测卵巢恶性肿瘤的灵敏性、特异性。结果 卵巢恶性肿瘤PI是 0 5 4± 0 15 ,良性为 1 48± 0 6 5 ;恶性肿瘤RI为 0 40± 0 0 94,良性为 0 85± 0 0 99(P<0 0 0 1)。卵巢恶性肿瘤 10 0 %可见血管 ,并定位于肿瘤中心 (96 4% ) ,92 9%无舒张期切迹 ;良性肿瘤46 3 %可见血管 ,并定位于肿瘤周边 (94 7% ) ,89 5 %可见舒张期切迹。以 0 76为PI界值 ,其预测卵巢恶性肿瘤的敏感性、特异性及阳性和阴性预测率分别为 92 9%、94 7%、96 3 %和 90 0 % ;以 0 5 6为RI界值 ,其敏感性、特异性及阳性和阴性预测率分别为 89 3 %、94 7%、96 2 %和 85 7%。结论 经腹彩色多普勒超声观察血管定位、搏动指数。

Objective To study the localization of blood vessels and the shape of blood flow curve in tumor image for the differentiation between benign and malignant ovarian tumors.Methods 28 patients diagnosed histologically as malignant ovarian tumors and 41 with benign ones were studied by trans-abdominal color Doppler ultrasonography,in cluding the localization of blood vessels in tumor images,the pulsatility index(PI),the resistance index(RI) and the diastolic notch in the tumor profiles.The PI and RI were compared with histopathological findings of the surgical specimens,and the sensitivity and the specificity of the diagnosis of ovarian malignancy were predicted.Results The mean values of PI were 0 54±0 15 in malignant tumors and 1 48±0 65 in benign ones,that of RI were 0 40±0 094 and 0 85±0 099 respectively(P<0 001).Blood vessels could be visualized in 100% of the malignant tumors and in 46 3% of the benign ones.Blood vessels tended to be localized centrally(96 4%) in malignant tumors and peripherally(94 7%) in benign ones.A diastolic notch was revealed in 89 5% of the benign tumors,but 92 9% of the malignant tumors showed no notch.As the limitation value was defined at 0 76 for PI,the sensitivity,specificity,positive and negative predictive rates for malignant tumor were 92 9%,94 7%,96 3% and 90 0%, respectively.The limitation value for RI being 0 56,the corresponding rates were 89 3%,94 7%,96 2% and 85 7%,respectively.Conclusion The localization of blood vessels,the PI and RI value and the presence or absence of a diastolic notch in the profile of an ovarian tumor image by color Doppler ultrasonography are ones of effective methods in evaluating the quality of ovarian tumors.