经阴道彩色多普勒超声在诊断早期卵巢癌的应用价值

The Value of Transvaginal Ultrasound in Early Diagnosis of Ovarian Malignancies

目的探讨经阴道超声(TVS)在早期卵巢癌诊断中的应用价值。方法应用TVS对71例卵巢肿瘤患者进行了检查。首先应用二维超声观察肿瘤的形态、内部回声、测量大小,然后应用能量多普勒超声观察肿瘤内血供情况,根据二维超声及能量多普勒超声(CDE)对肿瘤的良恶性做出诊断,并与术后的病理结果对照,评价二维超声及二维超声联合CDE诊断早期卵巢癌敏感性、特异性。结果 TVS诊断早期卵巢癌的符合率为85.7%,二维超声诊断早期卵巢癌的敏感性92.9%,特异性80.9%,阳性预测值76.4%,阴性预测值94.4%,Kappa=0.611(P<0.01);二维超声联合CDE诊断早期卵巢癌的敏感性92.9%,特异性88.4%,阳性预测值83.8%,阴性预测值95.0%,Kappa=0.797(P<0.01)。结论二维超声是诊断早期卵巢癌的基础,CDE能根据肿瘤血供特点对其良恶性提供参考依据,二者联合应用能提高早期卵巢癌的诊断符合率。

Objective To analyze the application value of transvaginal ultrasound in early diagnosis of ovari -an malignancies .Methods Seventy-one patients with ovarian tumor were diagnosed by transvaginal ultrasound , the tumor morphology ,echogram and size were obsereved by two-dimensional ultrasound .Then tumor blood flow was observed by Color Doppler energy ultrasound .The observations were compared with the pathologic results ,the sensitivity ,specifici-ty,positive predictive value ,negative predictive value and Kappa value of two-dimensional ultrasound and Color Doppler energy ultrasound were analyzed .Results The coincidence rate of diagnosis of early ovarian cancer is 85 .7%by trans-vaginal ultrasound .①The sensitivity ,specificity ,positive predictive value and negative predictive value of it was 92 .9%, 80.9%76.4%and 94.4%,Kappa=0.611,P〈0.01,when diagnosis of early stage ovarian cancer was diagnosised by two-dimensional ultrasound and Color Doppler energy ultrasound together ,by two-dimensional ultrasound;②its sensitivi-ty,specificity,positive predictive value and negative predictive value was 92.9%,88.4%,83.8%,95.0%,respectively, Kappa=0.797,P〈0.01.Conclusion The two-dimensional ultrasound is the basis of early diagnosis of ovarian cancer and CDE can provide the reference for benign and malignant according to the blood supply of the tumor characteristics . The combination of the two above can improve the coincidence rate of diagnosis of early ovarian cancer .