超声检查在盆腔囊性肿块病变诊断中的价值研究

Diagnostic value of ultrasonography in pelvic cystic mass

目的 探讨超声在盆腔囊性肿块病变中的诊断价值,以期为临床诊治盆腔囊性肿块提供参考。方法 选取2018年1月—2021年1月于沈阳市妇婴医院进行检查的120例盆腔囊性肿块患者作为研究对象。所有患者入院后均统一接受超声检查。分析不同性质囊性肿块的超声成像特征,并结合患者手术病理结果,对超声扫描的准确率、误诊率、漏诊率进行统计。结果 120例患者中检出良性肿块70例,恶性肿块50例。诊断准确率为92.50%(111/120)、误诊率为4.17%(5/120)、漏诊率为3.33%(4/120)。良性肿块超声特征:肿块直径较小、边界清晰且形状规则、回声分布较弱或无回声、盆腔附壁伴有声影光团、多为单侧呈现多房性特征、瘤壁增厚,但血流信号较弱,Adler血流分级多为1~2级、血流阻力指数RI均<0.7。恶性肿块超声特征:肿块直径较大、边界模糊且形状不规则、点状强回声分布、大量腹水且穿透性较差、瘤壁增厚,且内部血流信号丰富,Adler血流分级多为3级、血流阻力指数RI均≥0.7。结论 超声检查可通过对盆腔囊性肿块患者的肿块直径、边界、形状、回声分布及肿块内血流信号等参数进行观察,有效鉴别囊性肿块的良、恶性病变,其对疾病的诊断准确率较高,误诊、漏诊率较低,值得临床推广应用。

Objective To investigate the value of ultrasonography in the diagnosis of pelvic cystic masses, so as to provide a reference for clinical diagnosis and treatment of this disease. Methods A total of 120 patients with pelvic cystic mass who underwent examinations in Shenyang Women’s and Children’s Hospital from January 2018 to January 2021 were selected as the study subjects. All patients received the ultrasound examination after admission. The ultrasonographic features of patients with cystic masses of different natures were analyzed. The accuracy, misdiagnosis, and missed diagnosis rates of ultrasound scanning were statistically analyzed in combination with the results of surgical pathology. Results Of the 120 cases, 70 were benign and 50 were malignant. The diagnostic accuracy, misdiagnosis, and missed diagnosis rates were 92.50%(111/120), 4.17%(5/120), and 3.33%(4/120), respectively. Ultrasonographic features of benign masses: the diameter of the mass was small, the boundary was clear and the shape was regular, the echo distribution was weak or anechoic, the pelvic wall was accompanied by acoustic shadow light mass, and most of them presented multilocular features unilaterally. The tumor wall was thickened but the blood flow signal was weak, the Adler blood flow grade was mostly grade 1-2, and the blood flow resistance index RI was <0.7. Ultrasonographic features of malignant mass: large diameter, blurred boundary and irregular shape, punctate hyperechoic distribution, massive ascites, poor penetration, rich blood flow signals inside the thickened tumor wall, Adler blood flow grade mostly grade 3, and blood flow resistance index RI≥0.7. Conclusion Ultrasonography can effectively differentiate benign and malignant cystic masses by observing the diameter, boundary, shape, echo distribution, and blood flow signal in pelvic cystic masses. It has a high diagnostic accuracy for diseases and a low rate of misdiagnosis and missed diagnosis. These benefits justify a wider application of this procedure in clinical practice.