CT及MRI显示卵巢血管和输卵管对附件区实性肿块的定位诊断

CT and MRI showed ovarian vascular and uterine tube in localization diagnosis of solid tumors at adnexa area

目的探讨CT及MRI显示卵巢血管和输卵管对附件区实性肿块的定位诊断价值。方法收集经手术病理证实的55侧（48例）卵巢肿瘤或外突型子宫肿瘤患者的CT或／和MRI资料，依据肿块与卵巢血管及输卵管的关系来识别肿块来源，并与术后病理结果对照。结果判定55侧肿块起源准确度94．55％（52／55）、敏感度100．00％（30／30）、特异度88．00％（22／25）、假阳性率12．00％（3／25）、假阴性率0．00％（0／301、阳性预测值90．91％（30／33）、阴性预测值100．00％（22／22），术前定位诊断与术后病理结果的一致性高（Kappa=0．89）。显示3条附属结构者对肿块起源判断准确率较1条、2条者高，但差异无统计学意义（P=0．35）。结论卵巢及卵巢血管和输卵管的显示对判断子宫来源和卵巢来源的实性肿块具有较高的诊断价值，显示的数量越多者诊断准确性越高。

Objective To estimate the value of the CT and MRI showed ovarian vessels and uterine tube in the localization diagnosis of solid tumors at adnexa area. Methods The CT or （and） MRI features of 55 （48 cases） tumors in ovarian or ectopic uterine proved by surgery and pathology were reviewed and compared with postoperative pathologic results. Results Of the 55 sides, the determine tumor origin accuracy was 94.55%（52/55）, the sensitivity 100.00% （30/30）, the specificity 88.00% （22/25）, the false positive rate 12.00% （3/25）, the false negative rate 0.00% （0/30）, the positive predictive value 90.91% （30/33）, and negative the predictive value 100.00% （22/22）. The preoperative positioning diagnosis had high consistency with the postoperative pathological results （Kappa=0.89）.The results showed that the accuracy of the 3 accessory structures was higher than that of the 1 and the 2, but with no statistical difference （P=0.35）. Conclusions The ovaries, ovarian vessels, and uterine tube are shown to have a high diagnostic value in determining the origin of uterine tumors and ovarian tumors. The showed number is proportional to the accuracy of the judgment result.