经阴道三维定向能量多普勒成像联合超声造影对卵巢蒂扭转的应用价值研究  

Application value of transvaginal three-dimensional directional power doppler imaging combined with contrast-enhanced ultrasound in torsion of ovarian pedicle

作　　者：陈芳 颜冬华[1] 黄晓文 张红玉 徐婉媚 萧倩敏 CHEN Fang;YAN Donghua;HUANG Xiaowen;ZHANG Hongyu;XU Wanmei;XIAO Qianmin(Department of Ultrasonography,Zhongshan Traditional Chinese Medicine Hospital,Zhongshan,Guangdong 528400,China)

机构地区：[1]中山市中医院超声科,广东中山528400

出　　处：《影像研究与医学应用》2023年第24期11-15,共5页Journal of Imaging Research and Medical Applications

基　　金：2019中山市社会公益科技研究项目(2019SYF05)。

摘　　要：目的:探讨经阴道三维定向能量多普勒成像联合超声造影对卵巢蒂扭转的诊断价值。方法:选取2018年1月—2021年4月于中山市中医院就诊的疑似卵巢蒂扭转的患者115例,采用经阴道三维定向能量多普勒成像和超声造影进行检查,获取蒂部血管三维空间分布特征和超声造影特征等相关参数,并以手术病理结果为金对照,进行一致性分析,计算准确率、灵敏度、特异度、误诊率、漏诊率,评估两种方法及其联合应用对卵巢蒂扭转的诊断价值。结果:研究共纳入115例病例,经手术病理证实卵巢蒂扭转阳性组病例共61例,阴性对照组共54例。经阴道三维定向能量多普勒成像显示“双肿块征”具备诊断价值;经阴道三维定向能量多普勒成像诊断阳性51例、阴性64例、误诊11例、漏诊21例;超声造影诊断阳性55例、阴性60例、误诊20例、漏诊26例;联合检查诊断阳性58例、阴性57例、误诊5例、漏诊8例。联合检查诊断卵巢蒂扭转准确率、灵敏度、特异度均高于经阴道三维定向能量多普勒成像、超声造影单一检查,误诊率、漏诊率均低于经阴道三维定向能量多普勒成像、超声造影单一检查,同“金标准”一致性较好(Kappa值=0.774)。结论:经阴道三维定向能量多普勒成像及超声造影的联合应用较二者单一应用对卵巢蒂扭转有较高的诊断效能,值得临床推广应用。Objective To investigate the value of transvaginal three-dimensional directional power Doppler imaging combined with contrast-enhanced ultrasound(CEUS)in the diagnosis of ovarian pedicle torsion.Methods 115 patients with suspected ovarian torsion who visited Zhongshan Traditional Chinese Medicine Hospital from January 2018 to April 2021 were selected.All patients were examined by transvaginal three-dimensional directional power Doppler imaging and contrast-enhanced ultrasonography.The three-dimensional distribution characteristics of pedicle vessels and contrast-enhanced ultrasound and other related parameters were obtained.Compared with the surgical and pathological results,the consistency analysis was carried out,and the accuracy,sensitivity,specificity,misdiagnosis rate and missed diagnosis rate were calculated,to evaluate the diagnostic value of the two methods and their combined application in ovarian pedicle torsion.Results A total of 115 cases were included in the study.61 cases in the positive group and 54 cases in the negative control group were confirmed by operation and pathology.Transvaginal three-dimensional directional power Doppler imaging showed that"double mass sign"had diagnostic value,and transvaginal three-dimensional directional power Doppler imaging diagnosed positive in 51 cases,negative in 64 cases,misdiagnosis in 11 cases and missed diagnosis in 21 cases.Contrast-enhanced ultrasound diagnosis was positive in 55 cases,negative in 60 cases,misdiagnosis in 20 cases,missed diagnosis in 26 cases,combined diagnosis in 58 cases,negative in 57 cases,misdiagnosis in 5 cases and missed diagnosis in 8 cases.The accuracy,sensitivity and specificity of combined examination in the diagnosis of ovarian pedicle torsion were higher than those of transvaginal three-dimensional directional power Doppler imaging and contrast-enhanced ultrasound single examination.The misdiagnosis rate and missed diagnosis rate were lower than those of transvaginal three-dimensional directional power Doppler imaging and contr

关 键 词：经阴道三维定向能量多普勒成像 超声造影 卵巢蒂扭转 

分 类 号：R445.1[医药卫生—影像医学与核医学]