CT联合血清CA125在外突性肌瘤与卵巢性索间质肿瘤的鉴别诊断价值  

Value of CT combined with serum CA125 in the differential diagnosis of an evaginated uterine fibroid and ovarian sex cord stromal tumor

作　　者：何重阳 刘楠 陈翼 He Chongyang;Liu Nan;Chen Yi(Radiology Department,Chongqing Red Cross Hospital/Jiangbei People's Hospital)

机构地区：[1]重庆市红十字会医院(江北区人民医院)放射科,重庆400020

出　　处：《重庆医科大学学报》2022年第9期1083-1088,共6页Journal of Chongqing Medical University

摘　　要：目的:探讨多排螺旋计算机断层扫描(multi-slice spiral computer tomography,MSCT)联合血清CA125在外突性肌瘤与卵巢性索间质肿瘤的鉴别诊断价值。方法:回顾性分析经病理证实的外突性肌瘤(A组)63例、卵巢性索间质肿瘤(B组)51例,CT图像分别观察2组肿瘤供血动脉、卵巢静脉与肿瘤的关系、肿瘤强化特点、有无腹水,作出CT诊断;再结合血清CA125结果作出最终诊断,以病理结果为金标准,比较2组肿瘤中2种方法的诊断准确率。结果:A组肿瘤由子宫动脉子宫支伴或不伴卵巢动脉供血;追踪卵巢静脉多数可见正常卵巢组织;肿瘤强化明显,可见“漩涡征”;血清CA125多为正常,不易合并腹水;B组肿瘤主要由卵巢动脉伴或不伴子宫动脉卵巢支供血;可见卵巢血管蒂征(ovarian vascular sign,OVPS),追踪卵巢静脉不能显示完整卵巢组织;增强后肿瘤无或轻度延迟强化,血清CA125多升高,常合并腹水。2组肿瘤单独CT诊断准确率分别为90.48%(57/63)、80.39%(41/51),联合血清CA125诊断准确率分别为93.65%(59/63)、86.27%(44/51)。结论:根据肿瘤的CT特点并结合血清CA125结果,对女性盆腔内外突性肌瘤及卵巢性索间质肿瘤有较高的鉴别诊断效能。Objective:To explore the value of multi-slice spiral computer tomography(MSCT) combined with serum CA125 in the differential diagnosis of evaginated uterine fibroids and ovarian sex cord stromal tumors. Methods:A retrospective analysis of 63 cases of pathologically confirmed evaginated uterine fibroids(group A) and 51 cases of ovarian sex cord stromal tumors(group B) was performed. CT images were used to observe the blood supply arteries,relationships of ovarian veins and tumors of the two groups,tumor enhancement characteristics,presence or absence of ascites;meanwhile CT diagnosis was made combined with serum CA125 results,using pathological results as the gold standard to detect the diagnostic accuracy of the two methods. Results:In group A,the tumor was supplied by the uterine artery and uterine branch with or without ovarian artery. Normal ovarian tissue can be seen through the ovarian vein in most cases. Tumor enhancement is obvious,with “whirlpool sign”. Serum CA125 is mostly normal,and it is not easy to be combined with ascites. In group B :The tumor was mainly supplied by the ovarian artery with or without uterine artery and ovarian branch. Ovarian vascular sign(OVPS) could be seen,and tracking the ovarian vein couldn’t show intact ovarian tissue. After enhancement,the tumor had no or mild delayed enhancement,and the serum CA125 increased,combined with ascites. The diagnostic accuracy rates of CT in group A and B were 90.48%(57/63)and 80.39%(41/51),respectively,and combined with serum CA125 for tumors the figures were 93.65%(59/63) and 86.27%(44/51),respectively. Conclusion:According to the CT characteristics of the tumor and the results of serum CA125,it has a higher differential diagnostic efficacy for female pelvic evaginated uterine fibroids and ovarian sex cord stromal tumors.

关 键 词：外突性肌瘤 性索间质肿瘤 多排螺旋计算机断层扫描术 CA125 诊断 

分 类 号：R737.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]