经阴道常规超声联合三维能量多普勒超声在卵巢肿瘤鉴别诊断及预后评估中的应用研究

Application of Transvaginal Conventional Ultrasound Combined with Three-dimensional Energy Doppler Ultrasound in the Differential Diagnosis and Prognostic Evaluation of Ovarian Tumors

目的:探讨经阴道常规超声联合三维能量多普勒超声(3D-PDUS)在卵巢肿瘤鉴别诊断及预后评估中的应用价值。方法:回顾性分析2019年10月—2022年10月永城市妇幼保健院收治的104例卵巢肿瘤患者临床资料,根据病理诊断分为恶性组(33例)与良性组(71例)。比较两组患者经阴道常规超声、3D-PDUS诊断资料,探讨经阴道常规超声联合3D-PDUS在卵巢肿瘤鉴别诊断中的价值。结果:恶性组患者病灶形状不规则占比、内部回声实性/囊实性占比、有腹水占比均大于良性组,差异有统计学意义(χ^(2)=7.462、12.726、8.255,P<0.05);恶性组患者血管血流指数(VFI)、血流指数(FI)、内部血管指数(VI)高于良性组,差异有统计学意义(t=7.279、5.018、6.915,P<0.05)。logistic回归分析结果显示,经阴道常规超声征象病灶形状、内部回声、腹水和3D-PDUS参数VFI、FI、VI均与卵巢肿瘤良恶性质有关(OR>1,P<0.05);受试者工作曲线(ROC)显示,联合诊断回归模型鉴别卵巢肿瘤良恶性的曲线下面积(AUC)为0.905,有一定诊断价值。结论:经阴道常规超声征象和3D-PDUS参数均可用于鉴别卵巢肿瘤,两者联合在卵巢肿瘤鉴别诊断及预后评估中具有较高应用价值。

Objective:To investigate the value of transvaginal conventional ultrasound combined with three-dimensional energy Doppler ultrasound(3D-PDUS)in the differential diagnosis and prognostic evaluation of ovarian tumors.Methods:The clinical data of 104 patients with ovarian tumors admitted to the hospital from October 2019 to October 2022 were retrospectively analyzed and divided into malignant group(33 cases)and benign group(71 cases)according to pathological diagnosis.The diagnostic data of transvaginal conventional ultrasound and 3D-PDUS were compared between the two groups of patients,and the value of transvaginal conventional ultrasound combined with 3D-PDUS in the differential diagnosis of ovarian tumors was explored.Results:The percentage of lesions with irregular shape,the percentage of solid/cystic solid internal echogenicity,and the percentage of having ascites in the malignant group were greater than those in the benign group,and the difference was statistically significant(χ^(2)=7.462,12.726,8.255;P<0.05).The vascular flow index(VFI),flow index(FI),and internal vascular index(VI)of the malignant group were higher than those of the benign group,and the differences were statistically significant(t=7.279,5.018,6.915;P<0.05).The results of logistic regression analysis showed that transvaginal routine ultrasound signs of lesion shape,internal echoes,ascites,and 3D-PDUS parameters VFI,FI,and VI were associated with the benign and malignant nature of ovarian tumors(OR>1,P<0.05).The working curve(ROC)of the subjects showed that the area under the curve(AUC)of the combined diagnostic regression model to identify benign and malignant ovarian tumors was 0.905,which has some diagnostic value.Conclusion:Both routine transvaginal ultrasound signs and 3D-PDUS parameters can be used to identify ovarian tumors,and the combination of the two has high application value in the differential diagnosis and prognostic evaluation of ovarian tumors.