SMI、CDFI检查联合GI-RADS分类对卵巢肿瘤良恶性评估价值

The value of SMI,CDFI combined with GI-RADS in the evaluation of benign and malignant ovarian tumors

目的探讨超微血管成像(SMI)、彩色多普勒超声血流显像(CDFI)检查联合超声妇科影像报告和数据系统(GI-RADS)分类对卵巢肿瘤良恶性的评估价值。方法选取2019年9月至2022年3月富平县医院收治的168例卵巢肿瘤患者的临床资料,根据穿刺或术后病理组织检查结果分为恶性组(n=56)和良性组(n=112)。采用SMI和CDFI检查分别观察同一肿瘤血流情况,采用Adler分级标准评估病灶血流丰富程度,观察病灶血管条数。以GI-RADS分类1~4a类为良性,4b~5类为恶性,SMI检查、CDFI检查或GI-RADS分类任一参数为恶性则诊断为联合预测结果恶性。通过一致性分析,分别评价GI-RADS分类、CDFI检查联合GI-RADS分类、SMI检查联合GI-RADS分类对卵巢肿瘤恶性的预测价值。结果两组GI-RADS分类患者例数比较,差异有统计学意义(P<0.05)。恶性组SMI检查和CDFI检查血流丰富程度均明显高于良性组,差异均有统计学意义(P<0.05);恶性组SMI检查血流丰富程度明显高于CDFI检查,差异有统计学意义(P<0.05);良性组SMI和CDFI检查血流丰富程度比较,差异无统计学意义(P>0.05),SMI检查较CDFI检查更易检出恶性肿瘤中的3级血流。恶性组SMI和CDFI检查检出血管条数均明显多于良性组,差异均有统计学意义(P<0.05)。168例卵巢肿瘤患者中GI-RADS分类预测恶性49例,灵敏度为0.875,特异度为0.902,准确率为0.893,Kappa值为0.751;168例卵巢肿瘤患者中CDFI检查联合GI-RADS分类预测恶性53例,灵敏度为0.946,特异度为0.938,准确率为0.940,Kappa值为0.868;168例卵巢肿瘤患者中SMI检查联合GI-RADS分类预测恶性55例,灵敏度为0.982,特异度为0.955,准确率为0.964,Kappa值为0.921。结论SMI检查、GI-RADS分类对卵巢肿瘤良恶性均具有较好的鉴别诊断效能,SMI检查联合GI-RADS分类较CDFI检查联合GI-RADS分类诊断的灵敏度、特异度更高。

Objective To investigate the value of superb microvascular imaging(SMI),color Doppler flow imaging(CDFI)examination combined with ultrasound gynecological image reporting and data system(GI-RADS)classification in the evaluation of benign and malignant ovarian tumors.Methods The clinical data of 168 patients with ovarian tumors admitted to Fuping County Hospital from September 2019 to March 2022 were selected.According to the results of puncture or postoperative pathological tissue examination,they were divided into malignant group(n=56)and benign group(n=112).SMI and CDFI examination were used to observe the blood flow of the same tumor,Adler grading standard was used to evaluate the degree of blood flow,and the number of blood vessels in the lesion was observed.Benign lesions were defined as GI-RADS classification 1-4a,malignant lesions were defined as GI-RADS classification 4b-5.SMI examination,CDFI examination or any parameter of GI-RADS classification is malignant,the diagnosis is malignant combined prediction result.The predictive value of GI-RADS classification,CDFI examination combined with GI-GRADS classification and SMI examination combined with GI-RADS classification for the malignancy of ovarian tumors was evaluated by consistency analysis.Results There was statistically significant difference in the number of patients with GI-RADS classification between the 2 groups(P<0.05).The blood flow richness of SMI and CDFI examination in malignant group was significantly more than that in benign group,and the differences were statistically significant(P<0.05).The blood flow richness of SMI examination in malignant group was significantly higher than that of CDFI examination,and the difference was statistically significant(P<0.05).There was no significant difference in blood flow richness between SMI and CDFI examination in benign group(P>0.05).SMI examination is more likely to detect grade 3 blood flow in malignant tumors than CDFI examination.The number of blood vessels detected by SMI and CDFI examination in malignant group was significantly more than that in benign group,and the differences were statistically significant(P<0.05).Among 168 ovarian tumor patients,GI-RADS classification predicted malignant in 49 cases,the sensitivity was 0.875,the specificity was 0.902,the accuracy was 0.893,and the Kappa value was 0.751.Among 168 patients with ovarian tumors,CDFI examination combined with GI-RADS classification predicted 53 malignant cases,with a sensitivity of 0.946,a specificity of 0.938,an accuracy of 0.940,and a Kappa value of 0.868.Among 168 patients with ovarian tumors,SMI examination combined with GI-RADS classification predicted 55 malignant cases,the sensitivity was 0.982,the specificity was 0.955,the accuracy was 0.964,and the Kappa value was 0.921.Conclusion SMI examination and GI-RADS classification have good diagnostic efficiency for benign and malignant ovarian tumors.SMI combined with GI-RADS classification has higher sensitivity and specificity than CDFI examination combined with GI-RADS classification.