超声造影在附件实性小肿块鉴别诊断中的应用  

The Use of Contrast-enhanced Ultrasound In the Differential Diagnosis of Small Solid Adnexal Masses

作　　者：尹晶[1] 冯玉玲[1] 向红[1] 古丽娜尔.沙海 刘慧[1] 

机构地区：[1]新疆医科大学第一附属医院超声医学中心妇产超声科,新疆乌鲁木齐市830054

出　　处：《中国全科医学》2014年第6期719-722,共4页Chinese General Practice

基　　金：国家自然科学基金项目(30960101);新疆维吾尔自治区自然科学基金项目(200821144)

摘　　要：目的探讨超声造影在附件实性小肿块良恶性鉴别诊断中的价值。方法选取2009年8月—2013年2月在新疆医科大学第一附属医院就诊经腹部超声或经阴道超声检查后发现有附件小肿块(直径≤4 cm),且在二维超声显像上呈低/中/高回声,或以实性为主的混合性回声的连续性患者58例,共59枚肿块。对59枚附件实性小肿块进行超声造影检查,根据其特征提出超声造影评分系统。将超声造影结果与手术病理和长期随访结果对照,并对超声造影评分系统作出评价。结果 59枚附件小肿块中良性46枚,恶性13枚。良性与恶性小肿块在灌注模式、血管形态、灌注强度、时间-强度曲线形态及峰值强度比较,差异均有统计学意义(P<0.05)。超声造影评分系统诊断附件小肿块良恶性的敏感度为92.31%、特异度为95.65%、阳性预测值为85.71%、阴性预测值为97.78%、阳性似然比为21.22、阴性似然比为0.08、符合度为94.92%、Kappa值为0.86。结论超声造影评分系统对诊断附件实性小肿块能更加准确地判定其良恶性,有助于附件恶性肿瘤的早期诊断。Objective To explore the value of contrast -enhanced ultrasound （CEUS） in the differential diagnosis of small solid adnexal masses （≤4 cm） . Methods A total of 58 patients who were treated in the first affiliated hospital of Xin- jiang medical university from August 2009 to February 2013 were selected as study subjects, 59 small （ ~〈4 cm） adnexal masses were found by transabdominal or transvaginal sonography, the masses showed low/medium/high echo on the two - dimensional ul- trasound imaging, or mixed echoes with mainly solid echo. All of 59 solid adnexal masses were examined by CEUS, a new CEUS scoring system was developed according to the characteristics of solid adnexal masses. Results of CEUS were compared with surgi- cal pathology findings and long - term follow - up results so as to evaluate the CEUS scoring system. Results There were 46 be- nign masses and 13 malignant masses among 59 small adnexal masses. There were significant differences in perfusion pattern, vas- cular morphology, perfusion intensity, curve shape and peak score between benign masses and malignant masses （ P 〈 0. 05 ）. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ：ratio, fitness rate and Kappa value of CEUS scoring system in the differential diagnosis of small solid adnexal masses （ benign or malignant） was 92. 31%, 95.65%, 85.71%, 97. 78%, 21.22, 0. 08, 94. 92% and 0. 86 respectively. Conclusion The CEUS scoring system can accurately tell the difference between benign and malignant, which may contribute to diagnose malignant adnexal tumor early.

关 键 词：超声检查 血管造影术 子宫附件 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学]