超声在阑尾黏液性肿瘤危险度评估中的价值  

Value of Ultrasound in Assessing the Risk of Appendiceal Mucinous Neoplasms

作　　者：王雨萌 李岩[2] 刘冬[1] Wang Yumeng;Li Yan;Liu Dong(Department of Ultrasound Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Ultrasound Medicine,Hebei Provincial People's Hospital Physical Examination Center,Shijiazhuang 050051,China)

机构地区：[1]首都医科大学附属北京友谊医院超声医学科,北京市100050 [2]河北省人民医院体检中心超声医学科,石家庄市050051

出　　处：《中国超声医学杂志》2023年第7期787-790,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声检查对阑尾黏液性肿瘤术前危险度评估的实用价值。方法回顾性分析33例经手术病理证实的阑尾黏液性肿瘤患者的超声图像和临床资料,以病理结果为金标准分为低危组和高危组,分析比较两组的超声图像特征,通过受试者工作特征(ROC)曲线评估诊断效能,并构建决策树。结果超声图像特征中肿瘤边界、形态、内部回声均匀性、囊实性、内部钙化、内部血流信号、是否侵犯周围组织及腹盆腔积液情况在低危组和高危组组间差异有统计学意义。在高危组的诊断效能方面,内部回声均匀性的灵敏度最高,为100%,侵犯周围组织和腹盆腔积液的特异度最高,均为100%。内部回声均匀性和内部钙化情况ROC曲线下面积(AUC)较高,分别为0.860和0.817。构建的决策树在本研究中鉴别高危组阑尾黏液性肿瘤的灵敏度为100%,特异度为92%,准确度为93.8%。结论内部回声均匀性和内部钙化等超声指标在不同危险度的阑尾黏液性肿瘤间具有差异性,综合利用上述超声指标可以在术前对黏液性肿瘤的危险度进行初步评价,具有临床指导意义。Objective To evaluate the practical value of ultrasonography in preoperative risk assessment of appendiceal mucinous neoplasms.Methods The preoperative ultrasound findings and clinical data of 33 cases with mucinous appendiceal neoplasms confirmed by operation and pathology were retrospectively analyzed.All of them were divided into low-risk group and high-risk group according to the surgical pathological diagnosis as the gold standard.The ultrasonic characteristics of both groups were analyzed,the diagnostic efficacy was evaluated by receiver operating characteristic(ROC)curve,and the decision tree was constructed.Results The differences of tumor boundary,shape,echo homogeneity,cystic and solid,internal calcification,internal blood flow signal,invasion in surrounding tissues and ascites were statistically significant between the low-risk group and the high-risk group.In terms of diagnostic efficacy,the internal echo homogeneity had the highest sensitivity and the surrounding tissue invasion and ascites had the highest specificity,both of 100%.The internal echo homogeneity and internal calcification had the highest area under the receiver operating characteristic curve(AUC)of 0.860 and 0.817.In this study,the sensitivity,specificity and accuracy of decision tree in identifying appendiceal mucinous neoplasms in the high-risk group were 100%,92%and 93.8%.Conclusions There are differences in internal echo homogeneity and internal calcification between different risk groups of appendiceal mucinous tumors.A comprehensive analysis of ultrasonographic signs is helpful to evaluate the risk of appendiceal mucinous neoplasms preliminarily before surgery,which has clinical significance.

关 键 词：阑尾黏液性肿瘤 危险度 超声特征 诊断效能 决策树 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.36[医药卫生—诊断学]