卵巢子宫内膜异位症与卵巢癌患者经阴道超声影像学特征比较

Comparison of Transvaginal Ultrasound Imaging Features in Ovarian Endometriosis and Ovarian Cancer

目的:比较卵巢子宫内膜异位症与卵巢癌患者经阴道超声影像学特征,为二者的鉴别诊断提供参考。方法:选择2020年1月—2021年6月郑州市第七人民医院收治的90例卵巢子宫内膜异位症患者与90例卵巢癌患者,均行经阴道彩色多普勒超声检查,比较两组患者的超声检出率,肿块最大直径、阻力指数(RI)、搏动指数(PI)、收缩期峰值血流速度(PSV)、舒张末期流速(EDV)及声像囊肿分型。结果:经阴道超声对卵巢子宫内膜异位症与卵巢癌的检出率分别为90.00%、88.89%,差异无统计学意义(χ^(2)=0.847,P>0.05)。卵巢子宫内膜异位症患者的RI[(0.57±0.12) VS (0.40±0.08)]及PI[(1.25±0.38) VS (0.79±0.16)]明显高于卵巢癌,差异有统计学意义(χ^(2)=2.793、2.907,P<0.05),PSV[(22.46±3.74) cm/s VS (25.18±4.49) cm/s]及EDV[(10.33±2.14) cm/s VS (14.76±4.09) cm/s]明显低于卵巢癌,差异有统计学意义(χ^(2)=2.815、2.952,P<0.05)。两组患者之间肿块最大直径比较,差异无统计学意义(χ^(2)=0.758,P>0.05)。卵巢子宫内膜异位症(Ⅱ型12例、Ⅲ型36例、Ⅳ型20例、Ⅴ型15例、Ⅵ型7例)与卵巢癌(Ⅳ型11例、Ⅴ型36例、Ⅵ型43例)的声像囊肿分型比较,差异有统计学意义(χ^(2)=7.253、9.264、7.048、8.406、9.825,P<0.05)。结论:经阴道超声对卵巢子宫内膜异位症与卵巢癌的检出率均较高,可通过RI、PI、PSV、EDV及声像囊肿分型等超声影像学特征并结合临床特征进行鉴别诊断。

Objective:To compare the transvaginal ultrasound imaging features of ovarian endometriosis and ovarian cancer to provide a reference for the differential diagnosis of the two.Methods:90 patients with ovarian endometriosis and 90 patients with ovarian cancer admitted to the hospital from January 2020 to June 2021 were selected to undergo transvaginal color Doppler ultraso⁃nography.The ultrasound detection rate,maximum mass diameter,resistance index(RI),pulsatility index(PI),peak systolic flow ve⁃locity(PSV),end-diastolic flow velocity(EDV)and sonographic cyst staging were compared between the two groups.Results:The detection rates of ovarian endometriosis and ovarian cancer by transvaginal ultrasound were 90.00%and 88.89%,respectively,with no statistically significant difference(χ^(2)=0.847,P>0.05).The RI([0.57±0.12])and PI([1.25±0.38])were significantly higher in pa⁃tients with ovarian endometriosis than in patients with ovarian cancer([0.40±0.08],[0.79±0.16]),with statistically significant dif⁃ferences(χ^(2)=2.793,2.907,P<0.05).PSV([22.46±3.74]cm/s)and EDV([10.33±2.14]cm/s)were significantly lower than those of ovarian cancer patients([25.18±4.49]cm/s,[14.76±4.09]cm/s),with statistically significant differences(χ^(2)=2.815,2.952,P<0.05).There was no statistically significant difference in the maximum diameter of the mass between the two groups of patients(χ^(2)=0.758,P>0.05).The differences were statistically significant when comparing the sonographic cyst typing of ovarian endometriosis(12 cases of type II,36 cases of type III,20 cases of type IV,15 cases of type V,and 7 cases of type VI)with ovarian cancer(11 cases of type IV,36 cases of type V,and 43 cases of type VI,χ^(2)=7.253,9.264,7.048,8.406,9.825,P<0.05).Conclusion:Transvaginal ul⁃trasound has a high detection rate for both ovarian endometriosis and ovarian cancer.The differential diagnosis can be made by ul⁃trasound imaging features such as RI,PI,PSV,EDV and sonographic cyst staging,along with clinical features.