阻力指数和搏动指数联合恶性危险指数对卵巢肿瘤术前评估的价值  

Application of blood flow resistance index plus the risk of malignant index in preoperative assessment of ovarian neoplasm

作　　者：侯志敏[1] 杜秀英[2] 

机构地区：[1]天津市人民医院妇产科,300121 [2]天津市人民医院超声诊断科

出　　处：《中国综合临床》2013年第11期1129-1132,共4页Clinical Medicine of China

摘　　要：目的探讨阻力指数（RI）和搏动指数（PI）联合恶性危险指数（RMI）预测卵巢肿瘤性质的可行性，提高卵巢肿瘤术前诊断的准确性。方法选取我院2007年1月至2012年12月收治的30岁以上的卵巢肿瘤患者468例，其中恶性肿瘤127例（恶性肿瘤组），良性肿瘤341例（良性肿瘤组），分别应用RI＋PI、RMI以及RI＋PI联合RMI的方法进行回顾性预测分析。结果恶性肿瘤组和良性肿瘤组R1分别为0．41±0．08和0．68±0．15，P1分别为0．82±0．24和1．67±0．71，恶性肿瘤组RI、PI均低于良性肿瘤组（t=28．83，P〈0．01；t=22．26，P〈0．01）。恶性肿瘤组和良性肿瘤组RMl分别为269．7±41．2和25．6±11．4，恶性肿瘤组RMI高于良性肿瘤组（t=107．55，P〈0．01）。分别以RI〈0．40和（或）PI〈1．00、RMI〉200作为预测恶性肿瘤的标准，以术后组织病理学诊断作为判断肿瘤性质的金标准，RI、PI联合RMI与RI、PI和RMI单独使用预测卵巢肿瘤性质的敏感性分别为92．57％、81．02％和84．21％。RI、PI联合RMI预测卵巢肿瘤性质的敏感性高于RI＋PI和RMI单独使用（P均〈0．05），对卵巢肿瘤性质的预测价值优于各指标单独应用，其敏感性、特异性、阳性和阴性预测值均高于90％。结论RI和PI检测联合RMI评分可提高术前预测卵巢肿瘤性质的准确性，是一种值得临床应用的方法。Objective To investigate the possibility of blood flow resistance index （RI）, pulse index （PI） plus the risk of malignant index （RMI） in preoperative diagnosis of ovarian neoplasm. Methods Four hundred and sixty-eight women with ovarian tumor,30 years or older, were enrolled in current study from January 2007 to December 2012 in the People＇s Hospital of Tianjin. Among them, 127 were with malignant ovarian tumors and 341 with benign ovarian tumors. They were retrospectively prospective assessed by RI ± PI, RMI, and RI ± PI combine with RMI. Results The value of RI, PI of malignant ovarian tumors group were lower than those of benign ovarian tumors group（ （0. 41 ± 0. 08 ） vs （ 0. 68 ± 0. 15 ）, t = 28.83, P 〈 0. 01 ; （0. 82 ± 0. 24） vs （ 1.67 ± 0. 71 ）, t = 22. 26, P 〈 0. 01 ）. RMI of malignant ovarian tumors group was （269.7 ± 41.2 ）, higher than that of benign ovarian tumors group（25.6± 11.4 ,t = 107. 55 ,P 〈0. 01 ）. The indices of RI 〈0. 40 and/or PI 〈1.00,RMI 〉 200 were served as the critical biomarker respectively. Histopathological examination result was conducted and considered as gold standard for identifying patients with ovarian cancer pelvic masses. The sensitivity of RI,PI plus RMI was 92.57%, higher than that used by RI and P1 （$1.02%） or RMI only （84.21%） ,and the difference was significant （ P 〈 0.05 ）. The sensitivity, specificity , positive and negative predictive values of the combined index of RI, PI adding to RMI were all higher than 90%. Cotlelusiort The combined index of RI, PI plus RMI was proved to enhance the diagnostic accuracy regarding of the preoperative diagnosis of benign or malignant ovarian tumors.

关 键 词：卵巢肿瘤 彩色多普勒超声 阻力指数 搏动指数 恶性危险指数 

分 类 号：R737.31[医药卫生—肿瘤]