常规超声及介入性超声在诊断原发性卵巢癌腹膜转移中的应用价值

Conventional ultrasound and interventional ultrasound in diagnosis peritoneal metastasis of ovarian cancer

目的:探讨常规超声及介入性超声对卵巢癌腹膜转移的诊断价值。方法:对195例高度疑似卵巢癌患者行术前经腹式(transabdominal ultrasonography,TAUS)、经阴式(transvaginal ultrasonography,TVUS)的常规超声检查,扫查卵巢及腹膜、腹水等情况,对于异常腹膜进行超声引导下穿刺活检,与术后病理进行对比。结果:术后病理证实195例患者确诊为原发性卵巢癌,其中136例伴有腹膜转移。TAUS、TVUS以及TAUS+TVUS三种常规超声检查方式的诊断结果不同,其中以TAUS+TVUS的灵敏性、特异性、诊断准确率最高,分别为62.50%、94.92%、72.30%。腹水是常规超声对腹膜转移诊断的影响因素之一。TAUS+TVUS检查发现88例腹膜异常患者均行超声引导下穿刺活检,穿刺成功率为100%,与术后病理对比,灵敏性97.64%、特异性100%,诊断准确率为97.72%。结论:TAUS联合TVUS常规超声检查可在术前对卵巢癌腹膜转移情况进行较准确的影像学诊断,超声引导下穿刺活检可在术前为临床提供明确病理诊断,为卵巢癌的分期及治疗提供精确信息。

Objective：To explore the clinical diagnostic value of conventional ultrasound and interventional ultrasound in ovarian cancer peritoneal metastasis. Methods：Totally 195 patients with suspected ovarian cancer underwent transabdominal and transvaginal ultrasound examination to scan the ovarian peritoneal and ascites. The suspicious peritoneal underwent ultrasound- guided biopsy,and the results were compared with postoperative pathological. Results：All 195 cases were diagnosed with ovarian cancer by pathologically,which 136 cases associated with peritoneal metastasis. The conventional ultrasound diagnosis results of three groups by TAUS,TVUS and TAUS ＋ TVUS is different,among them TAUS ＋ TVUS had the highest sensitivity,specificity and diagnostic accuracy,62. 50%,94. 92% and72. 30% respectively. The conventional ultrasound diagnosis of ovarian cancer peritoneal metastasis associated with ascites. 88 patients with TAUS ＋ TVUS diagnostic abnormal peritoneal underwent ultrasound guided biopsy,The successful rate of biopsy was 1 0 0 %,the diagnostic accuracy rate of peritoneal biopsy was 97. 72%,Sensitivity was97. 64%,specificity was 100%. Conclusion：TAUS ＋ TVUS can be used to judge peritoneal metastasis of ovarian cancer in the preoperative imaging,ultrasound- guided biopsy can provide a clear pathology diagnosis for clinical and provide accurate information to the staging and treatment of ovarian cancer.