IOTA简易标准联合超声造影对附件区包块的诊断价值  

The Value of IOTA Simple Rules Combined with Contrast-enhanced Ultrasound in the Diagnosis of Adnexal Masses

作　　者：李蕴琦 向红[1] 吕晨阳 周慧丽[1] 付丽君 刘慧[1] Li Yunqi;Xiang Hong;LüChenyang;Zhou Huili;Fu Lijun;Liu Hui(Department of Ultrasound in Obstetrics and Gynecology,the First Affiliated Hospital of Xinjiang Medical University,Wulumuqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院妇产超声诊断科,乌鲁木齐市830054

出　　处：《中国超声医学杂志》2021年第11期1273-1277,共5页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金项目(No.30960101)。

摘　　要：目的探究国际卵巢肿瘤分析组织(IOTA)简易标准联合超声造影对附件区包块的诊断价值。方法选取附件包块129枚,以病理及长期随访结果作为金标准,运用诊断试验比较IOTA简易标准、超声造影及二者联合的方式对附件区包块的诊断价值。结果 (1)IOTA简易标准的灵敏度、特异度、符合率、ROC曲线下面积为91.42%、91.30%、91.35%、0.914(0.847~0.980),被简易标准判断为不确定性病例占总病例数的19.4%。(2)超声造影的上述诊断指标为94.59%、94.56%、94.57%、0.946(0.896~0.996),根据超声造影评分表绘制造影评分ROC曲线,取整将14分作为最佳诊断截点,当造影评分≥14分时,判为恶性血流丰富特征。(3)简易标准联合超声造影的上述诊断指标为97.29%、95.65%、96.12%、0.965(0.926~1.000),对比前两种单一诊断方式,简易标准联合超声造影ROC曲线下面积最大,灵敏度及特异度都有所提高。结论 IOTA简易标准联合超声造影在判断附件区包块良恶性方面具有较高的诊断价值并提高了准确率,能弥补部分病例无法用简易标准定性诊断的局限性,为附件包块的临床诊断及治疗提供有力依据。Objective To explore the diagnostic value of International Ovarian Tumor Analysis(IOTA) simple rules combined with contrast-enhanced ultrasound(CEUS) in the diagnosis of adnexal masses. Methods 129 adnexal masses were selected, pathological and long-term follow-up results were used as the gold standard, The diagnostic test was used to compare the diagnostic value of IOTA simple rules, CEUS and the combined diagnostic method of the two for the adnexal mass.Results(1)The sensitivity, specificity, coincidence rate, and area under the receiver operating characteristic(ROC) curve of simple rules were 91.42%, 91.30%, 91.35%, and 0.914(0.847-0.980).Uncertain cases judged by simple rules accounted for 19.4% of the total cases.(2)The above indexes of CEUS were 94.59%, 94.56%, 94.57%, 0.946(0.896-0.996).Draw the ROC curve of the CEUS score, 14 points were used as the best diagnostic cut-off point. When the angiography score was ≥14, it was judged as malignant, with rich blood flow characteristics.(3)The above indicators of IOTA simple rules combined with CEUS were 97.29%, 95.65%, 96.12%, 0.965(0.926-1.000).Compared with the previous two single diagnosis methods, combined diagnosis of the two had the largest area under the ROC curve, the diagnostic performance was the best and the sensitivity and specificity were improved. Conclusions IOTA simple rules combined with CEUS has high diagnostic value and improved accuracy in judging benign and malignant masses in the adnexal area, which can make up for the limitation that some cases cannot be diagnosed by simple rules, which provide a strong basis for the clinical diagnosis of adnexal masses.

关 键 词：国际卵巢肿瘤分析组织 超声造影 附件包块 

分 类 号：R737.31[医药卫生—肿瘤] R445.1[医药卫生—临床医学]