探讨多模态超声诊断卵巢GI-RADS 4类肿块的价值  

Investigate the Value of Multimodal Ultrasound in the Diagnosis of Ovarian Masses of GI-RADS 4

作　　者：刘春 李媛[1] 朱熠[1] 李旭 林静 卢漫[1] Liu Chun;Li Yuan;Zhu Yi;Li Xu;Lin Jing;Lu Man(Department of Ultrasound,Sichuan Cancer Hospital,Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院超声医学中心,成都市610041

出　　处：《中国超声医学杂志》2022年第4期414-417,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨多模态超声在GI-RADS 4类卵巢肿块良恶性鉴别诊断中的临床应用价值。方法选取超声诊断为GI-RADS 4类的202个卵巢肿块为研究对象,所有患者术前均接受经阴道常规超声、SWE及CEUS检查。以术后病理结果为金标准,计算SWE、CEUS及多模态超声(CEUS+SWE)的灵敏度、特异度、阳性预测值、阴性预测值、准确度,并绘制ROC曲线比较三者的诊断效能。结果卵巢良恶性病变造影增强表现、增强水平、包膜是否完整、包膜厚薄是否均匀、造影剂分布及血管走形比较,差异显著(P<0.01)。恶性病变组最大弹性模量值(Emax)和平均弹性模量值(Emean)均大于良性病变组(P<0.05)。多模态超声诊断的灵敏度、准确度及AUC均显著高于CEUS、SWE(P<0.05)。结论CEUS、SWE及多模态超声在诊断卵巢GI-RADS 4类肿块的良恶性方面均具有临床应用价值,其中多模态超声诊断的灵敏度及准确度最高。Objective To explore the clinical value of multimodal ultrasound in the differential diagnosis of benign and malignant ovarian masses of GI-RADS 4.Methods A total of 202 ovarian masses diagnosed as GI-RADS 4 by ultrasound in our hospital were selected as the study objects.All patients received conventional transvaginal ultrasound,shear wave elastic imaging(SWE)and contrast-enhanced ultrasound(CEUS)before surgery.Using postoperative pathological results as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of SWE,CEUS and multimodal ultrasound(CEUS+SWE)were calculated,and the diagnostic efficacy of the three was compared by drawing ROC curves.Results There were significant differences in contrast enhancement performance,enhancement level,capsule intact or incomplete,uniform or uneven capsule thickness,contrast medium distribution and vascular shape between benign and malignant ovarian masses(P<0.01).The maximum elasticity(Emax)and mean elasticity(Emean)in malignant lesions were higher than those in benign lesions(P<0.05).The sensitivity,accuracy and AUC of multimodal ultrasonic diagnosis were significantly higher than CEUS and SWE(P<0.05).Conclusions CEUS,SWE and multimodal ultrasound have clinical value in the diagnosis of benign and malignant ovarian masses of GI-RADS 4,and multimodal ultrasound has the highest sensitivity and accuracy.

关 键 词：卵巢肿瘤 妇科影像报告与数据系统 多模态超声 

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]