二维超声及超声造影对卵巢肿瘤的诊断价值研究

Diagnostic value of two-dimensional ultrasound and contrast-enhanced ultrasound in ovarian tumors

目的比较二维超声及超声造影对卵巢肿瘤的诊断价值。方法选取90例卵巢恶性肿瘤患者和70例卵巢良性肿瘤患者,比较良恶性卵巢肿瘤的二维超声和超声造影特征及相关参数,以组织病理学结果作为金标准,比较二维超声和超声造影对卵巢恶性肿瘤的诊断效能。结果卵巢恶性肿瘤壁结节、沙粒状钙化、回声不均的比例及血流阻力指数(RI)和Alaczar超声评分分别为61.1%、33.3%、67.8%、(0.61±0.28)及(6.02±1.95)分,均高于卵巢良性肿瘤的37.1%、18.6%、51.4%、(0.45±0.19)及(3.68±1.65)分,差异均有统计学意义(P﹤0.05)。卵巢恶性肿瘤的开始增强时间、增强峰值时间及开始消退时间均明显短于卵巢良性肿瘤,峰值强度明显高于卵巢良性肿瘤,上升支斜率明显小于卵巢良性肿瘤(P﹤0.01)。峰值强度、上升支斜率、RI及Alaczar超声评分中,峰值强度诊断卵巢恶性肿瘤的效能最高,受试者工作特征(ROC)曲线下面积为0.913,灵敏度和特异度分别为100%和93.5%;其次为上升支斜率,RI的诊断效能最低。结论二维超声及超声造影能够显示卵巢肿瘤的形态学特征,其中超声造影参数峰值强度诊断卵巢恶性肿瘤的效能最高。

Objective To compare the diagnostic value of two-dimensional(2D)ultrasound and contrast-enhanced ultrasound(CEUS)in ovarian tumors.Method The 90 cases with malignant ovarian tumors and 70 cases with benign ovarian tumors were collected to compare the findings observed using 2D ultrasound and CEUS,with pathological results as gold standard,the diagnostic efficiency of 2D ultrasound and CEUS for ovarian malignant tumors were compared.Result In malignant ovarian tumors,the percentage of tumor wall nodule,sand-like calcifications,ratio of nonhomogeneous echo pattern and resistance index(RI),and Alaczar ultrasound score was 61.1%,33.3%,67.8%,(0.61±0.28)and(6.02±1.95),which were higher than those in benign ovarian tumors at 37.1%,18.6%,51.4%,(0.45±0.19)and(3.68±1.65),respectively,and the differences were of statistical significance(P<0.05).The wash-in time,peak enhancement time and wash-out time in malignant ovarian tumors were all significantly shorter compared to benign ones,with higher peak intensity and lower rise slope than those in benign ovarian tumors(P<0.01).Among the parameters comprising peak intensity,rise slope,RI and Alaczar ultrasound score,peak intensity had the highest diagnostic efficiency,with the maximum area under the receiver operator characteristic(ROC)curve of 0.913,and the sensitivity and specificity were 100%and 93.5%,respectively;the second highest efficiency was noted in rise slope,while RI had the lowest power for diagnosis.Conclusion 2D ultrasound and CEUS can definitely reveal the morphological features of ovarian tumors,and among all the related ultrasound parameters,the peak intensity is the most effective one.