妇科恶性肿瘤淋巴结及大网膜转移的超声预测价值

Preoperative ultrasound study in predicting lymph node and greater omentum metastasis for gynecologic malignant tumor patients

目的 探讨妇科恶性肿瘤术前超声预测淋巴结和大网膜有否转移的临床价值。方法 采用二维超声和彩色多普勒血流显像 (CDFI)观察 45例妇科恶性肿瘤患者大网膜和腹主动脉、髂总、髂外、髂内、闭孔动脉旁淋巴结声像图情况。结果 超声术前预测大网膜和淋巴结癌转移准确性分别为 88.9%和 88.9% ,敏感性分别为 80 .0 %和 82 .4% ,特异性分别为 96 .0 %和 92 .9% ,阴性预测值 85 .7%和 89.7% ,阳性预测值分别为94.1%和 87.5 %。伴大网膜和淋巴结癌转移患者中肿瘤内血流信号丰富者高于无大网膜和淋巴结癌转移者 (P<0 .0 1)。伴有大网膜癌转移者瘤体内血流阻力指数RI值 <0 .5 0者 6 5 .0 % ,无大网膜癌转移者为 12 .0 % (P<0 .0 1)。

Objective To study the value of ultrasonography in preoperative predicting whether or not lymph node and greater omentum produce metastasis for patients of gynecologic malignant tumors.Methods Forty five patients with greater omentum and lymph node of para aorta,iliaca communis,iliaca interna,iliaca externa and obturatoria were observed by 2 D US and CDFI.Results About the prediction of greater omentum and lymph node metastasis,their accuracies were 88.9% and 88.9% ,sensitivities were 80.0% and 82.4% ,specificities were 96.0% and 92.9% ,negative prediction rates were 85.7% and 89.7% ,positive prediction rates were 94.1% and 87.5% ,respectively.In the patients with greater omentum and lymph node metastasis blood flow inside tumors was richer than those without metastasis of greater omentum and lymph node (P<0.01).In the patients involved with greater omentum metastasis RI values less than 0.50 were 65.0% ,and those without involvement were 12.0% (P< 0.01 ).Conclusions It provides an effective method for predicting whether there are lymph node and greater omentum metas tasis in gynecologic malignant tumor and for the stage division and the choice of its clinical treatment plan.