基于CT成像的附件扭转卵巢活性的预测模型  

A Model to Predict Ovarian Viability of Adnexal Torsion at Computed Tomography

作　　者：段娜[1] 王绍娟[1] 胡旭宇[1] 朱丽 邹俊婷 陈苓珊 王中秋[1] DUAN Na;WANG Shaojuan;HU Xuyu(Department of Radiology,the Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing,Jiangsu Province 210029 P.R.China)

机构地区：[1]南京中医药大学附属医院放射科,210029

出　　处：《临床放射学杂志》2022年第11期2090-2094,共5页Journal of Clinical Radiology

摘　　要：目的探讨计算机断层扫描(CT)在预测附件扭转患者卵巢活力的价值。方法搜集72例经手术证实并进行术前CT扫描的附件扭转患者。三位放射科医师独立评估CT图像。病例分为卵巢保留和卵巢切除两组,两组之间比较临床基线资料、病理结果和CT特征。使用多变量逻辑回归分析评估与卵巢坏死相关的危险因素。结果CT特征的观察者间一致性Kappa值为0.656~0.850。年龄(OR=1.289,95%CI:1.104~1.505,P=0.002)和扭转蒂出血(OR=31.150,95%CI:1.820~233.232,P=0.005)是扭转卵巢坏死的独立预测因素,结合年龄和蒂出血2个指标的曲线下面积为0.931。结论扭转蒂的出血和患者年龄是预测附件扭转患者卵巢活力的因素。组合模型在预测附件扭转卵巢坏死上有较好的效能。Objective To assess the value of computed tomography(CT)in predicting ovarian viability in patients with adnexal torsion.Methods This retrospective study included 72 patients with a preoperative CT scan and surgically verified adnexal torsion.Three radiologists independently evaluated the CT images.The patients’demographics,pathologic results and CT features were compared between patients that received conservative surgery and salpingo-oophorectomy.Risk factors associated with adnexal necrosis were assessed using multivariate logistic regression analysis.Results Interobserver agreement of CT features varied between substantial and almost perfect(Kappa value=0.656~0.850).Age(OR=1.289,95%CI:1.104~1.505,P=0.002)and pedicle hemorrhage(OR=31.150,95%CI:1.820~233.232,P=0.005)were independently predictors for necrosis in patients with adnexal torsion,and an area under the curve(AUC)was0.931 for the combined two indicators.Conclusion CT features of pedicle hemorrhage and patients’age are predictors of ovarian viability in patients with adnexal torsion.The combined model showed great potential in predicting adnexal necrosis.

关 键 词：扭转 卵巢坏死 蒂出血 计算机断层扫描 

分 类 号：R711.75[医药卫生—妇产科学]