经阴道彩色多普勒超声诊断卵巢畸胎瘤的临床价值研究

Clinical Value of Transvaginal Color Doppler Ultrasound in the Diagnosis of Ovarian Teratoma

目的:探讨经阴道彩色多普勒超声诊断卵巢畸胎瘤的临床价值。方法:回顾性分析大连市妇女儿童医疗中心(集团)2018年9月~2020年9月妇科就诊的卵巢畸胎瘤患者66例,术前均进行经阴道彩色多普勒超声检查,经阴道彩色多普勒超声诊断结果与术后病理学结果相比,计算经阴道彩色多普勒超声诊断卵巢畸胎瘤的正确率及误诊率,并分析卵巢畸胎瘤的彩色多普勒超声图像特征。结果:经阴道彩色多普勒超声术前诊断卵巢畸胎瘤59例,其中诊断为成熟型52例,未成熟型7例,成熟型畸胎瘤主要超声表现为纯囊性、囊实混合性及类实性,未成熟畸胎瘤主要超声表现为实性。经术后病理学证实卵巢畸胎瘤患者共66例,术前经阴道彩色多普勒超声正确诊断卵巢畸胎瘤59例,诊断正确率为89.39%。其中经阴道彩色多普勒超声误诊6例,误诊率为9.09%,其中3例误诊为卵巢囊腺瘤,1例误诊为卵巢浆液性囊腺癌,2例误诊为单纯卵巢囊肿,1例漏诊。卵巢畸胎瘤的彩色多普勒超声图像主要表现为肿块为实性、类实性、纯囊性以及囊实混合性。结论:卵巢畸胎瘤的彩色多普勒超声表现具有一定的特征性,经阴道彩色多普勒超声诊断卵巢畸胎瘤的准确性较高,具有较高的敏感性及特异性,并且能够对卵巢畸胎瘤进行初步分型,是诊断卵巢畸胎瘤首选方法,能为临床提供重要的参考价值。

Objective:To investigate the clinical value of transvaginal color Doppler ultrasound in the diagnosis of ovarian teratoma.Methods:66 patients with ovarian teratoma in Dalian Women and Children Medical Center(Group)from September 2018 to September 2020 were retrospectively analyzed.All patients underwent transvaginal color Doppler ultrasound before operation.The diagnostic results of transvaginal color Doppler ultrasound were compared with the postoperative pathological results,and the accuracy and misdiagnosis rate of transvaginal color Doppler ultrasound in the diagnosis of ovarian teratoma were calculated,the characteristics of color Doppler ultrasound of ovarian teratoma were analyzed.Results:59 cases of ovarian teratoma were diagnosed by transvaginal color Doppler ultrasound before operation,including 52 cases of mature teratoma and 7 cases of immature teratoma.Mature teratoma mainly manifested as pure cystic,mixed cystic and solid like,while immature teratoma mainly manifested as solid.66 cases of ovarian teratoma were confirmed by postoperative pathology.59 cases of ovarian teratoma were correctly diagnosed by transvaginal color Doppler ultrasound before operation,and the diagnostic accuracy was 89.39%.Among them,6 cases were misdiagnosed by transvaginal color Doppler ultrasound,the misdiagnosis rate was 9.09%,of which 3 cases were misdiagnosed as ovarian cystadenoma,1 case was misdiagnosed as ovarian serous cystadenocarcinoma,2 cases were misdiagnosed as simple ovarian cyst,and 1 case was missed.The color Doppler ultrasound images of ovarian teratoma mainly showed solid,solid like,pure cystic and mixed cystic and solid masses.Conclusion:The color Doppler ultrasonography of ovarian teratoma has certain characteristics.Transvaginal color Doppler ultrasonography has high accuracy,sensitivity and specificity in the diagnosis of ovarian teratoma,and can preliminarily classify ovarian teratoma.It is the first choice for the diagnosis of ovarian teratoma and can provide important reference value for clinic.