三维超声及微血管密度在卵巢浆液性肿瘤病理性质中的研究  

Study on three-dimensional ultrasound and microvessel density in serous ovarian tumors

作　　者：薛红霞[1] 庞玉兰[1] 焦彤[2] 

机构地区：[1]天津中医药大学,天津300073 [2]天津市人民医院超声诊疗科,天津300121

出　　处：《生物医学工程与临床》2015年第2期131-135,139,共6页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨良、恶性卵巢浆液性肿瘤三维超声形态特征及三维能量多普勒（3D-CPA）血流特点,并与病理微血管密度（MVD）进行相关性研究,为临床浆液性肿瘤的诊断提供依据。方法选择76例经手术切除的卵巢浆液性肿瘤患者,年龄26~71岁,平均年龄48.7岁。依据术后病理性质分为良性组（30例,病理结果为良性浆液性囊腺瘤,囊内可见分隔或乳头样实性组织,不包括单纯性浆液性囊腺瘤）、交界性组（24例,病理结果为交界性浆液性囊腺瘤）、Ⅰ期癌组（22例,病理结果为浆液性囊腺癌,国际妇产科联盟卵巢癌分期为Ⅰ期）。术前均经三维超声对肿瘤形态和血流进行观察,比较肿瘤直径、分隔数、分隔厚度、实性组织切面总面积、血流分级、血管指数（VI）。所选病例均进行免疫组织化学分析,计数MVD,研究超声测量结果与MVD的相关性。结果 3组之间分隔数、分隔厚度比较,良性组〈交界性组及Ⅰ期癌组（P〈0.05）,交界性组与Ⅰ期癌组差异无统计学意义;3组肿瘤内实性组织切面总面积比较,良性组〈交界性组〈Ⅰ期癌组（P〈0.05）,肿瘤直径差异无统计学意义（P〉0.05）。3D-CPA血管分级良性组以Ⅰ级血流多见,交界性组、Ⅰ期癌组以Ⅱ、Ⅲ级尤其以Ⅱ级多见;VI值比较,良性组〈交界性组〈Ⅰ期癌组（P〈0.05）。MVD 3组间存在差异,相关性分析显示,分隔数、分隔厚度、实性组织切面总面积与MVD呈正相关（r=0.247、0.469、0.717,P〈0.05）,其中,分隔厚度、实性组织切面总面积相关性较好。MVD与肿瘤直径无显著相关性。交界性组、Ⅰ期癌组3D-CPA血管分级与MVD呈正相关（r=0.52、0.57,P〈0.05）,VI与MVD亦呈正相关（r=0.49、0.58,P〈0.05）。结论三维超声观察卵巢肿瘤的形态及血流信号可提高对卵巢浆液性肿瘤良恶性的初步鉴别,为临床诊治提供依据。Objective To explore the three-dimensional ultrasonic morphology and three-dimensional color and power Doppler angiography（3D-CPA） blood flow characteristics of benign and malignant serous ovarian tumor and study their relationship with pathological microvessel density（MVD）, which provide ultrasonic basis for clinical diagnosis. Methods A total of 76 cases of serous ovarian tumors with operation resection were enrolled, who were aged 26- 71 years old with mean age of 48.7 years old. They were divided into 3 groups accorded to pathological results after operation： benign group（n = 30, pathologic result was benign serous cystadenoma with sac septation or papillary solid tissue, excluded pure serous cystadenoma）, borderline group（n = 24, borderline serous cystadenoma） and stageⅠgroup（n = 22, serous cystadenocarcinoma, stage Ⅰof International Federation of Gynecology and Obstetrics）. 3D-CPA was performed before operation, and the tumor diameter, number and thickness of septa, total sectional area of solid tissue, blood grading and vascular index（VI） were compared. All the slices of tumor tissue were analyzed by immunohistochemistry, and MVD was calculated. The results were compared and correlation between MVD and clinical stages were analyzed. Results The number and thickness of septa in benign group were significantly lower than that of borderline group and malignant group（P〈0.05）, whereas the difference between borderline group and malignant group was not significant. The total solid sectional tissue area was benign group〈 borderline group 〈stage Ⅰgroup（P〈0.05）, and the tumor diameter was not significantly different（P〉0.05）. The blood grading of benign group belonged to grade Ⅰ or Ⅱ, and borderline group and stageⅠ group were gradeⅡ and Ⅲ with grade Ⅱ as the majority. The VI result was benign group borderline group stage Ⅰ group（P〈0.05）. The MVD was different among 3 groups, and correlation analysis showed that the number and thickness of sep

关 键 词：卵巢肿瘤 三维超声 三维能量多普勒超声 微血管密度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]