超声造影在卵巢肿瘤良恶性鉴别及卵巢肿瘤血管评估中的应用

Application of Contrast-enhanced Ultrasonography in the Identification of Benign and Malignant Ovarian Tumors and the Evaluation of Ovarian Tumors

目的:分析超声造影(CEUS)在卵巢肿瘤良恶性鉴别及卵巢肿瘤血管评估中的应用。方法:选取郑州大学第一附属医院2020年1月至2022年1月收治的86例卵巢肿瘤患者进行术前CEUS及动态增强磁共振成像(DCE-MRI)检查,术中切除肿瘤标本并于术后进行免疫组化法检测,血管内皮细胞以CD34单克隆抗体标记并计算肿瘤微血管密度(MVD),分析CEUS、DCE-MRI参数与MVD的相关性。结果:CEUS成像正确诊断80例,DCE-MRI成像正确诊断78例,CEUS成像诊断灵敏度、特异度、准确度分别为90.32%、94.55%、93.02%,阳性、阴性预测值分别为90.32%、94.55%;DCE-MRI成像诊断的灵敏度、特异度、准确度分别为87.10%、92.73%、90.70%,阳性、阴性预测值分别为87.10%、92.73%;恶性组峰值强度(PI)、曲线下面积(AUC)、血管外细胞外间隙容积比值(V_(e))、容积转移常数(K^(trans))值水平明显高于良性组,达峰时间(TTP)、到达时间(AT)水平明显低于良性组,差异具有统计学意义(P<0.05);Pearson相关分析显示,PI、AUC、K^(trans)、V_(e)与MVD呈正相关,TTP、AT与MVD呈负相关。结论:CEUS可有效鉴别卵巢良恶性肿瘤,准确评估卵巢肿瘤血管密度。

Objective To analyze the application of contrast-enhanced ultrasonography(CEUS)in the differentiation of benign and malignant ovarian tumors and the evaluation of ovarian tumor blood vessels.Methods A total of 86 patients with ovarian tumor admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to January 2022 were selected for preoperative CEUS and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI).Tumor specimens were resected and immunohistochemistry was performed after surgery.Vascular endothelial cells were labeled with CD34 monoclonal antibody and tumor microvascular density(MVD)was calculated.The correlation between CEUS and DCE-MRI parameters and MVD was analyzed.Results 80 cases were correctly diagnosed by CEUS imaging,78 cases were correctly diagnosed by DCE-MRI imaging.The sensitivity,specificity and accuracy of CEUS imaging were 90.32%,94.55%,93.2%,positive and negative predictive values were 90.32%,94.55%,respectively.The diagnostic sensitivity,specificity and accuracy of DCE-MRI were 87.10%,92.73%,90.70%,positive and negative predictive values were 87.10%,92.73%,respectively.Peak intensity(PI),area under curve(AUC),volume ratio of extracellular space(V_(e))and volume transfer constant(K^(trans))in malignant group were significantly higher than those in the benign group,the time to peak intensity(TTP)and arrival time(AT)were significantly lower than those in the benign group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that PI,AUC,K^(trans),V_(e) were positively correlated with MVD,while TTP,AT were negatively correlated with MVD.Conclusion CEUS can effectively identify benign and malignant ovarian tumors and accurately evaluate the blood vessels of ovarian tumors.