CT及MRI联合血清CA199诊断盆腔子宫内膜异位囊肿的临床研究

Clinical study of CT and MRI combined with serum CA199 in the diagnosis of pelvic endometriosis cyst

目的探讨电子计算机断层扫描(CT)、磁共振成像(MRI)联合血清糖类抗原199(CA199)在盆腔子宫内膜异位囊肿诊断中的应用。方法选取85例盆腔子宫内膜异位囊肿患者,以术后病理诊断为金标准,比较CT、MRI、血清CA199检查结果,评价不同检测方法对盆腔子宫内膜异位囊肿的诊断效能。结果85例盆腔子宫内膜异位囊肿患者经病理检查发现94个病灶,CT平扫68个囊肿密度均匀,26个密度不均;增强扫描后,94个囊肿的囊壁可见强化,包括24个明显强化及70个中轻度强化,所有囊肿的囊液无强化,CT检查准确率为89.41%(76/85),5例被误诊为畸胎瘤,4例被误诊为卵巢囊腺瘤。MRI检查中,子宫内膜异位囊肿一般表现为T1WI高而T2WI低的混杂信号,准确率为91.76%(78/85),其中2例误诊为附件炎,2例误诊为卵巢囊腺瘤。入组患者的血清CA199为(52.32±4.26)kU/L,诊断准确率为77.65%(66/85),三者联合的诊断准确率为98.82%(84/85),明显高于单独检测(χ^2分别=6.80、4.72、18.36,P均<0.05)。结论CT、MRI联合血清CA199在盆腔子宫内膜异位囊肿诊断鉴别中具有优势,三者联合的诊断准确度均高于单独检测。

Objective To explore the application of computerized tomography(CT)and magnetic resonance imaging(MRI)combined with serum carbohydrate antigen 199(CA199)in the diagnosis of pelvic endometriosis cyst.Methods Eighty-five patients with pelvic endometriosis cysts were enrolled.The examination results of CT,MRI and serum CA199 level were analyzed and their diagnostic efficiency for pelvic endometriosis cyst were evaluated.Results Of the 85 patients with pelvic endometriosis cysts,pathological examination showed that there were 94 lesions.CT plain scan showed that there were 68 lesions with uniform cyst density and 26 lesions with uneven density.After enhanced scan,there were 94 lesions with cysts wall enhancement,including 24 lesions with significant enhancement and 70 lesions with moderate enhancement.There was no cystic fluid enhancement in any cyst.The accuracy rate of CT examination was 89.41%(76/85).There were 5 cases misdiagnosed as teratomas and 4 cases misdiagnosed as ovarian cystadenoma.In MRI examination,endometriosis cysts almostly showed high signals on T1WI and low signals on T2WI,with accuracy rate of 91.76%(78/85).There were 2 cases misdiagnosed as annexitis and 2 cases misdiagnosed as ovarian cystadenoma.The serum CA199 level of the pelvic endometriosis cyst patients was(52.32±4.26)kU/L,with diagnostic accuracy rate of 77.65%(66/85).The diagnostic accuracy rate of the combination of three methods was 98.82%(84/85),which was significantly higher than that of single method(χ^2=6.80,4.72,18.36,P<0.05).Conclusion CT and MRI combined with serum CA199 is advantageous for the differential diagnosis of pelvic endometriosis cyst,whose accuracy is higher than that of single method.