超声造影联合CA125、阻力指数在诊断交界性卵巢肿瘤中的应用价值

The application value of contrast-enhanced ultrasound combined with CA125 and resistance index in the diagnosis of borderline ovarian tumors

目的探讨超声造影(contrast-enhanced ultrasound,CEUS)联合血清学CA125、阻力指数(resistance index,RI)在诊断交界性卵巢肿瘤(borderline ovarian tumors,BOTs)中的应用价值。方法回顾性分析2019年4月至2023年11月本院常规超声检查诊断的交界性卵巢肿物55例患者的彩色多普勒超声、CEUS及CA125,以病理诊断结果为金标准,采用受试者工作特征(ROC)曲线分析其诊断价值。结果55例患者中,术后病理诊断良性21例、交界性34例。CA125≥35 U/mL患者19例,其中良性组1例,交界组18例(P<0.05);良性组RI为0.55±0.13,而交界组为0.45±0.10(P<0.05);交界组CEUS时间强度曲线(time-intensity curve,TIC)的造影剂消退时间早于良性组(P<0.05),两组间到达时间及增强强度比较,差异无统计学意义(P>0.05)。CEUS诊断BOTs的敏感度、特异度和准确度分别为94.1%、47.6%和76.4%,CEUS联合CA125、RI诊断BOTs的敏感度、特异度、准确度和ROC曲线下面积(AUC)分别为85.3%、81.0%、83.6%和0.889,高于单一检测技术(均P<0.05)。结论超声造影联合CA125、阻力指数明显提高交界性卵巢肿瘤的诊断效能。

Objective To explore the application value of contrast-enhanced ultrasound(CEUS)combined with serum carbohydrate antigen 125(CA125)and resistance index(RI)in the diagnosis of borderline ovarian tumors(BOTs).Methods A retrospective analysis was conducted on 55 patients who underwent routine examinations and were suspected of having borderline ovarian tumors from April 2019 to November 2023.The study included conventional color Doppler ultrasound,contrast-enhanced ultrasound,and serum CA125 data.Using pathological diagnosis results as the gold standard,the diagnostic value of contrast-enhanced ultrasound for borderline ovarian tumors was assessed through the analysis of ROC curve.Results Among 55 patients based on conventional color Doppler ultrasound,postoperative pathology confirmed 21 cases as benign and 34 cases as borderline.The patients with CA125≥35 U/mL totaled 19 cases,with 1 case in the benign group and 18 cases in the borderline group(P<0.05).In addition,the resistance index(RI)was 0.55±0.13 in the benign group,while it was 0.45±0.10 in the borderline group(P<0.05).The results of the time-intensity curve(TIC)in contrast-enhanced ultrasound indicate that the washout time of the contrast agent in the borderline group is earlier than that in the benign group(P<0.05),while there is no significant difference in arrival time and enhancement intensity between the two groups.The sensitivity,specificity,and accuracy of contrast-enhanced ultrasound in diagnosing borderline ovarian tumors are 94.1%,47.6%,and 76.4%respectively.The sensitivity,specificity,accuracy,and the areas under the curve(AUC)of contrast-enhanced ultrasound combined with CA125 and RI in diagnosing borderline ovarian tumors were 85.3%,81.0%,83.6%,and 0.889,respectively,which were higher than those of single detection technology(all P<0.05).Conclusions Contrast-enhanced ultrasound combined with CA125 could significantly improve the diagnostic efficiency of borderline ovarian tumors.