多模态无创诊断技术在卵巢癌早期诊断中的价值研究

Study on the value of multimodal non-invasive diagnostic techniques in the early diagnosis of ovarian cancer

目的:探讨多模态无创诊断技术B超、CT及MRI检查在卵巢癌早期诊断中的价值。方法:选取医院组织病理学检查证实的114例卵巢癌患者纳入观察组,同期经临床证实非卵巢癌的卵巢囊实性包块的109例患者纳入对照组,两组患者均接受B超、CT及MRI检查,分析B超、CT及MRI单独检查以及B超+CT+MRI平行联合诊断和B超+CT+MRI系列联合诊断对卵巢癌的诊断价值。观察分析卵巢病变大小、数目及回声特征,以及诊断的灵敏度、特异度及准确率。结果:观察组经B超检查确诊卵巢癌100例,漏诊14例,误诊4例;CT检查确诊卵巢癌108例,漏诊6例,误诊2例;MRI检查确诊卵巢癌110例,漏诊4例,误诊1例。B超+CT+MRI平行联合诊断确诊卵巢癌114例,B超+CT+MRI系列联合诊断确诊卵巢癌96例。B超诊断的灵敏度、特异度及准确率分别为87.72%、96.33%和91.93%;CT分别为94.74%、98.17%和96.41%;MRI分别为96.49%、99.08%和97.76%;B超+CT+MRI平行联合诊断分别为100.00%、93.58%和96.86%;B超+CT+MRI系列联合诊断分别为84.21%、100.00%和91.93%。MRI诊断的灵敏度显著高于B超(χ^(2)=6.031,P<0.05),CT和MRI诊断的准确率显著高于B超(χ^(2)=4.084,χ^(2)=7.747;P<0.05)。平行联合诊断的灵敏度显著高于三者单独检查(χ^(2)=14.915,χ^(2)=6.162,χ^(2)=4.071;P<0.05)。结论:B超、CT及MRI对卵巢癌的早期诊断具有重要价值,三者平行联合诊断能显著提高诊断的灵敏度。

Objective:To explore the value of multimodal non-invasive diagnostic techniques included B-mode ultrasound,computed tomography(CT)and magnetic resonance imaging(MRI)examination in the early diagnosis of ovarian cancer.Methods:A total of 114 patients with ovarian cancer who were confirmed by histopathological examination in hospital were selected as observation group.At the same time,109 patients with solid mass of ovarian capsule but not ovarian cancer who were confirmed by clinical diagnosis were selected as control group.Both groups underwent B-mode ultrasound,CT and MRI examinations.The diagnostic values of alone B-mode ultrasound,CT and MRI,and the combined parallel diagnosis of B-mode ultrasound,CT and MRI,and the combined successive diagnosis of them on ovarian cancer were analyzed.And then,the size,amount,echo feature,diagnostic sensitivity,diagnostic specificity and diagnostic accuracy of ovarian lesion were further observed and analyzed.Results:In observation group,100 cases of ovarian cancer were confirmed by B-mode ultrasound,and 14 cases were missed diagnosis and 4 cases were misdiagnosed.And 108 cases of ovarian cancer were confirmed by CT,and 6 cases were missed diagnosis and 2 cases were misdiagnosed.110 cases of ovarian cancer were confirmed by MRI,and 4 cases were missed diagnosis and 1 case was misdiagnosed.On the other hand,114 cases were confirmed by the combined parallel diagnosis of B-mode ultrasound,CT and MRI,and 96 cases were confirmed by the combined successive diagnosis of them.The sensitivity,specificity and accuracy of B-mode ultrasound diagnosis were 87.72%,96.33%and 91.93%,and those indicators of CT diagnosis were 94.74%,98.17%and 96.41%,and those indicators of MRI diagnosis were 96.49%,99.08%and 97.76%,respectively.And the sensitivity,specificity and accuracy of combined parallel diagnosis of them were 100.00%,93.58%and 96.86%respectively.And the sensitivity,specificity and accuracy of combined successive diagnosis of them were 84.21%,100.00%and 91.93%,respectively.The sensitivity of MRI diagnosis was significantly higher than that of B-mode ultrasound(χ^(2)=6.031,P<0.05),and the diagnostic accuracies of CT and MRI were significantly higher than those of B-mode ultrasound(χ^(2)=4.084,χ^(2)=7.747,P<0.05).The sensitivity of combined parallel diagnosis was significantly higher than that of alone detection of each method(χ^(2)=14.915,χ^(2)=6.162,χ^(2)=4.071,P<0.05).Conclusion:B-mode ultrasound,CT and MRI have great value in the early diagnosis of ovarian cancer.And combined parallel diagnosis can significantly improve the sensitivity of diagnosis.