女性盆腹腔间皮瘤临床特点及彩色多普勒超声图像特征分析  

Clinical characteristics and the color Doppler ultrasound imaging features analysis in female pelvic and abdominal mesotheliomas

作　　者：安绍宇[1] 刘健[1] 田科[2] 刘军[2] 魏秋鑫[2] 

机构地区：[1]川北医学院附属医院超声科医学影像四川省重点实验室,四川南充637007 [2]四川省医学科学院四川省人民医院检验科,四川成都610072

出　　处：《生物医学工程与临床》2011年第5期427-430,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的总结女性盆腹腔良、恶性间皮瘤的临床特点及超声图像特征。方法 5例女性盆腹腔间皮瘤,年龄20~56岁,平均年龄38.8岁。病程10天~12个月。回顾性分析其临床资料（3例恶性间皮瘤,2例良性间皮瘤）,以及影像和实验室结果,重点分析其超声图像特征。结果 5例女性盆腹腔间皮瘤患者临床以腹胀腹痛、盆腔包块和（或）盆腹腔积液就诊。超声图像上有其特点：盆腔包块常呈囊实混合性回声,内部呈筛网状;血流信号特征显示恶性间皮瘤的包块内血流丰富,为2～3级血流信号,阻力指数范围为中等阻力指数（0.4～0.6）,良性间皮瘤的包块内几乎无血流信号显示。良、恶性间皮瘤均可见腹水,但不恒定出现。肿瘤标志物检查,所有间皮瘤患者的癌胚抗原（CEA）均低于正常参考值,恶性者的糖链抗原125（CA125）明显高于参考值,良性者的CA125位于参考值范围;术后标本免疫组织化学检查见4例calretinin为阳性（2例良性,2例恶性）;4例CK阳性表达（2例良性,2例恶性）。1例恶性病例中CT检查见腹膜增厚现象,1例恶性病例CT检查未见腹膜增厚显像。结论女性盆腹腔恶性间皮瘤超声图像有其特征性改变,结合患者典型的临床表现、CT特征及实验室相关指标,可大大提高对该病的诊断。Objective To summarize and analysis the clinical characteristics and the color Doppler ultrasound imaging features in female pelvic and abdominal mesotheliomas.Methods Five female patients with pelvic and abdominal mesotheliomas were enrolled,aged 20-56 years old,mean age 38.8 years old,course 10 days to 12 months,which were retrospectively analyzed（2 cases were benign and 3 cases were malignant） about clinical information,CT imaging,ultrasound imaging and laboratory test results.Results Five female with same clinical features,which were abdominal pain and abdominal distension,masses in pelvic and fluid in abdomen,but the fluid were not always found in every case.The ultrasound imaging had some characteristics： there were cystic solid mixed masses in pelvic,which looked like net interior.The color Doppler flow features were different between benign and malignant.The malignant masses had more flow signal than that of benign mass,and with 2-3 grade flow index and moderate resistance index（RI range 0.4-0.6）,however,benign mass had almost no flow signal in ultrasound imaging.In the tumor maker tests,carcino-embryonic antigen（CEA） expressed negative,CA125 had apparently increased in malignant case,while hardly increased in benign case.In immunohistochemistry test,calretinin and cytokinin（CK） expressed active in 4 cases（2 cases were benign,and 2 cases were malignant）.The peritoneal thickening could be observed in 1 malignant case,while another malignant case could not found peritoneal thickening in CT imaging.Conclusion It is demonstrated that the ultrasound imaging of female pelvic and abdominal mesotheliomas have some characteristics and combined with the clinical characteristic,laboratory findings and CT findings,the diagnosis accuracy rate would be greatly increased.

关 键 词：腹膜间皮瘤 临床特点 彩色多普勒超声显像 实验室检查 

分 类 号：R735[医药卫生—肿瘤]