经阴道超声诊断卵巢肿瘤的价值  

Value of transvaginal sonography in diagnosis of ovarian tumors

作　　者：唐丽娜[1] 任永富[1] 阎若元[1] 尚志红[1] 沈友洪[1] 陈静[1] 陈轶洁[1] 黄伟钦[1] 

机构地区：[1]福建省肿瘤医院超声科,350014

出　　处：《临床超声医学杂志》2007年第1期34-37,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨经阴道超声(TVCD)结合彩色多普勒超声在卵巢良恶性肿瘤诊断中的价值。方法经阴道超声对63例(78个)卵巢良恶性肿瘤的形态学进行评分,同时加用彩色多普勒超声血流检查。根据彩色血流分布分为Ⅰ、Ⅱ、Ⅲ三型,并检测肿块收缩期峰值流速(PSV)及阻力指数(RI)值,将诊断结果与手术病理相对照。结果以B超积分≥5诊断卵巢恶性肿瘤的特异性、敏感性及准确性分别为86.5%、83.9%、85.5%;以RI<0.45诊断卵巢恶性肿瘤的特异性、敏感性、准确性分别为85.3%、37.9%、63.5%。良性肿瘤血管多分布于肿瘤周边或隔上,以Ⅰ、Ⅱ型为主,而恶性肿瘤血供丰富,血管主要分布于肿瘤实质区,以Ⅲ型为主,两组间差异有极显著性。良恶性卵巢肿瘤的PSV之间有显著性差异。结论不能单独用RI或PSV等某一指标来评价肿瘤的性质,联合应用二维超声、CDFI及动力学指标,综合分析,可最大限度地提高对卵巢肿瘤的诊断准确性。Objective To investigate the diagnostic value of transvaginal sonngraphy（TVS）combined with color Dopplor flow imaging（CDFI）for benign and malignant ovarian tumors.Methods Morphological scores and CDFI grades were analyzed and compared with pathology. The morphological sonngraphy-eumulated score was divided into score 〈 5 and ≥ 5 as cut-off for benignity and malignancy respectively. The CDFI grades were divided into Ⅰ , Ⅱ , and Ⅲ according to blood flow distribution and vasculature. Results Using score t〉5 as standard for malignancy,the specificity,sensitivity and accuracy rate were 86.5% ,83.9% ,85.5% respectively. In benign tumors, no flow was seen or most flow signals distributed peripherally or septally. The vasculature was mainly Ⅰ and Ⅱ degrees. In malignant tumors, the vessels distributed in the tumor centers and mainly belonged to Ⅲ There was significant difference between benign and malignant tumors（ P 〈 0.001）. The dynamic index, peak systolic velocity（PSV） had significant difference between the two goups, but resistance index （RI） had no significance. As a cut-off was set at RI 〈 0.45, the specificity, sensitivity and accurate rate were 85.3 %, 37.9 % and 63.5 % respectively. Conclusion RI or PSV may not be used individually to differentiate benign and malignant ovarian tumors. Based on 2-D ultrasound for morphology, synthetic analysis of blood distribution and dynamics may elevate diagnostic accuracy for ovarian tumors maximally.

关 键 词：超声检查 多普勒 彩色 经阴道超声 卵巢肿瘤 

分 类 号：R714.22[医药卫生—妇产科学]