婴幼儿卵巢扭转的超声图像特征分析

Analysis of ultrasonographic features of ovarian torsion in infants

目的探讨婴幼儿卵巢扭转的超声影像特点。方法选取49例OT患儿为OT组,50例卵巢内有包块无OT患儿为对照组。观察分层、网格、厚壁、壁上结节、包膜下积液、卵巢回声增强伴增大滤泡、钙化、子囊、卵巢血流信号等超声特征,比较2组间差异,并用ROC曲线评价其诊断价值。结果超声检查卵巢扭转的敏感度为95.9%,特异度为72.0%,准确率为83.8%. ROC曲线下面积为0. 840.卵巢扭转组分层、卵巢回声增强伴增大滤泡、钙化和包膜下积液的检出率明显高于对照组(P<0.05或P<0.01),其余征象2组间差异均无统计学意义(P>0.05). ROC曲线分析显示,分层曲线下面积为0.817,敏感度65.3%,特异度为98.0%;卵巢回声增强伴增大滤泡曲线下面积为0.684,敏感度为36.7%,特异度为100.0%;钙化曲线下面积为0.613,敏感度为34.7%,特异度为88.0%;包膜下积液曲线下面积为0.551,敏感度为10.2%,特异度为100.0%。结论婴幼儿卵巢扭转的超声表现具有多样性和多变性,超声对其诊断的敏感性较高,是诊断及鉴别卵巢扭转的首选方法。分层对卵巢扭转的诊断价值最高,可为早期诊断卵巢扭转提供可靠的影像学依据。

Objective To investigate the ultrasonographic features of ovarian torsion ( OT) in infants. Methods Forty - nine infants with OT were selected as OT group, and 50 infants with ovarian mass but without OT were selected as control group. The ultrasonographic features of fluid - debris, grid, thick wall, supra - mural nodules, subcapsular effusion ,enhanced ovarian echo with enlarged follicles, calcification, ascus and ovarian blood flow signals were observed and compared between the two groups. The diagnostic value of ultrasonography was evaluated by ROC curve. Results The sensitivity, specificity and accuracy of ultrasonography for diagnosing OT were 95. 9%, 72.0% and 83. 8% respectively. The area under the ROC curve was 0. 840. The detection rates of fluid - debris, enhanced ovarian echo with enlarged follicles ,calcification and subcapsular effusion in the OT group were significantly higher than those in the control group ( P <0.05 or P <0.01), while other signs showed no significant difference between the two groups (P >0.05). The ROC curve showed that the area under the curve of fluid - debris was 0. 817, the sensitivity was 65.3% and the specificity was 98. 0%. The area under the curve of enhanced ovarian echo with enlarged follicles was 0. 684, the sensitivity was 36.7% and the specificity was 100.0%. The area under the curve of calcification was 0.613, the sensitivity was 34.7% and the specificity was 88.0%. The area under the curve of ovary subcapsular effusion was 0. 551, the sensitivity was 10. 2% and the specificity was 100.0%. Conclusion The ultrasonographic manifestations of OT in infants are diverse and variable. Ultrasonography has high sensitivity in the diagnosis of OT, and is the preferred method for the ultrasonographic assessment and differential diagnosis. Fluid - debris has the highest diagnostic value for OT and can provide reliable imaging basis for early diagnosis of OT.