超声妇科影像报告和数据系统分类与16层螺旋CT诊断良恶性卵巢肿瘤的价值

Value of ultrasound GI-RADS classification and 16-slice spiral CT in differential diagnosis of benign and malignant ovarian tumors

目的探讨超声妇科影像报告和数据系统(GI-RADS)分类与16层螺旋CT对良恶性卵巢肿瘤鉴别诊断价值。方法选取2015年1月~2019年8月在我院就诊的卵巢肿瘤患者85例为研究对象,分别进行超声及16层螺旋CT检查,采用GI-RADS系统评价超声声像图表现,并检测其癌胚抗原(CEA)水平。比较超声GI-RADS系统、16层螺旋CT联合CEA联合检查结果与病理学检查结果的一致性;以病理学检查结果为金标准,比较超声GI-RADS系统、16层螺旋CT联合CEA检查诊断鉴别良恶性卵巢肿瘤的灵敏度、特异度、阳性预测值、阴性预测值及诊断准确率,并采用ROC曲线分析超声GI-RADS系统、16层螺旋CT联合CEA检查对良恶性卵巢肿瘤的诊断鉴别价值。结果超声GI-RADS系统联合CEA检查结果与病理学检查结果的一致性(Kappa=0.791)大于16层螺旋CT联合CEA(Kappa=0.487);超声GI-RADS系统、16层螺旋CT联合CEA联合检查诊断良恶性卵巢肿瘤的灵敏度、特异度、恶性预测值、良性预测值对比,差异无统计学意义(P>0.05);超声GI-RADS系统联合CEA诊断良恶性卵巢肿瘤的准确率高于16层螺旋CT联合CEA(P<0.05);经ROC曲线分析得,超声GI-RADS系统联合CEA诊断良恶性卵巢肿瘤的AUC大于16层螺旋CT联合CEA(P<0.05)。结论超声GI-RADS系统联合CEA检测对良恶性卵巢肿瘤具有较高的诊断价值,且诊断准确率较高。

Objective To explore value of ultrasound gynecological image report and data system(GI-RADS)classification and 16-slice spiral CT in differential diagnosis of benign and malignant ovarian tumors.Methods A total of 85 patients with ovarian tumors treated in the hospital from January 2015 to August 2019 were enrolled as study objects.All underwent ultrasound and 16-slice spiral CT examination.GI-RADS was applied to evaluate performances of ultrasonic images,and to detect the CEA level.The pathological examination was performed on lesions.The consistency of ultrasound GI-RADS system and 16-slice spiral CT combined with CEA was compared with those of pathological examination.Using pathology test results as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of ultrasonic GI-RADS system,16 slice spiral CT combined with CEA were compared in the diagnosis of identification of benign and malignant ovarian tumors.ROC curve was used to analyze the diagnostic value of ultrasound gi-rads system,16 slice spiral CT combined with CEA in the diagnosis of benign and malignant ovarian tumors.Results The consistency of ultrasound GI-RADS combined CEA examination with pathological examination was higher than that of 16-slice spiral CT combined CEA(Kappa:0.791 vs 0.487).There were no significant differences in sensitivity,specificity,malignant predictive value and benign predictive value of the two methods for diagnosing benign and malignant ovarian tumors(P>0.05).The accuracy of ultrasound GI-RADS combined with CEA in the diagnosis of benign and malignant ovarian tumors was higher than that of 16-slice spiral CT combined with CEA(P<0.05).ROC curve analysis showed that AUC of ultrasound GI-RADS combined with CEA was greater than that of 16-slice spiral CT combined with CEA for diagnosing benign and malignant ovarian tumors(P<0.05).Conclusion The ultrasound GI-RADS with CEA is of relatively high diagnostic value for benign and malignant ovarian tumors,and its diagnostic accuracy is relatively high.