ADNEX模型联合三维能量多普勒超声鉴别卵巢肿瘤良恶性的价值  

Value of ADNEX model combined with three-dimensional power Doppler ultrasound in distinguishing benign and malignant ovarian tumors

作　　者：刘醒[1] 张又红[1] 林宇佳[1] LIU Xing;ZHANG Youhong;LIN Yujia(Ultrasound DepartmentⅢ,Meizhou People’s Hospital,Guangdong,Meizhou 514031,China)

机构地区：[1]广东省梅州市人民医院超声三科,广东梅州514031

出　　处：《中国医药科学》2024年第19期140-143,188,共5页China Medicine And Pharmacy

基　　金：广东省梅州市医药卫生科研课题(2023-B-40)。

摘　　要：目的探讨评估不同附件肿瘤(ADNEX)模型联合三维能量多普勒超声(3D-PDUS)鉴别卵巢肿瘤良恶性的临床应用价值。方法回顾性收集2022年10月至2023年6月于梅州市人民医院接受手术治疗并于术前进行过二维及三维超声检查的64例卵巢肿瘤患者的67个肿块,根据病理学分为良性组(40个)和恶性组(27个),分别进行ADNEX模型分析;比较良恶性卵巢肿瘤组间的3D-PDUS血流参数差异,筛选有意义的指标,并据此对ADNEX模型的诊断结果进行升级或降级;分别绘制ADNEX模型及联合3D-PDUS后诊断卵巢肿瘤的ROC曲线,比较ADNEX模型及联合3D-PDUS诊断卵巢肿瘤良恶性的价值。结果恶性组3D-PDUS的血管指数(VI)及血管-血流指数(VFI)值均高于良性组,差异有统计学意义(P<0.05);根据VI及VFI值对卵巢肿瘤的分级进行调整后,病理性质为良性的卵巢肿瘤中有8个被正确下调为良性,2个被错误上调为恶性;病理为恶性的卵巢肿瘤中有2个被错误下调为良性,1个被正确上调为恶性。ADNEX模型的AUC值为0.751(95%CI:0.631~0.871),敏感度为85.2%,特异度为65.0%,阳性预测值为62.2%,阴性预测值为86.7%;联合3D-PDUS后,AUC值为0.826(95%CI:0.719~0.932),敏感度为85.2%,特异度为80.0%,阳性预测值为74.2%,阴性预测值为88.9%,除敏感度外,各项诊断指标均有所提高。结论ADNEX模型联合3D-PDUS技术能更好地鉴别卵巢肿瘤的良恶性,在不降低敏感度的情况下,提升诊断特异度。Objective To explore and evaluate the clinical application value of different ADNEX(assessment of different neoplasias in the adnexa)model combined with 3D power Doppler ultrasound(3D-PDUS)in distinguishing benign from malignant ovarian tumors.Methods From October 2022 to June 2023,67 tumors of 64 patients with ovarian tumors who underwent surgical treatment in Meizhou People’s Hospital and underwent two-dimensional and three-dimensional ultrasound examination before operation were collected retrospectively.According to pathological classification,they were divided into benign group(40)and malignant group(27),and ADNEX model analysis was performed separately.The differences in 3D-PDUS blood flow parameters between benign and malignant ovarian tumor groups were compared,meaningful indicators were screened,and the diagnostic results of the ADNEX model were upgraded or downgraded based on this accordingly.The ROC curves of ADNEX model and 3D-PDUS in the diagnosis of ovarian tumors were drawn respectively,and the values of ADNEX model and 3D-PDUS in the diagnosis of benign and malignant ovarian tumors were compared.Results The vascularity index(VI)and vascularization-flow index(VFI)of 3D-PDUS in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).After adjusting the grading of ovarian tumors based on VI and VFI values,among the ovarian tumors with the pathological nature of benign,8 were correctly downgraded to benign and 2 were incorrectly upgraded to malignant,and 2 of the ovarian tumors with a malignant pathological nature were incorrectly downgraded to benign and one was correctly upgraded to malignant.The AUC value of the ADNEX model was 0.751(95%CI:0.631-0.871),with a sensit ivity of 85.2%,a specificity of 65.0%,a positive predictive value of 62.2%,and a negative predictive value of 86.7%.After joining forces with 3D-PDUS,the AUC value was 0.826(95%CI:0.719-0.932),with a sensitivity of 85.2%,a specificity of 80.0%,a positive predictive valu

关 键 词：评估不同附件肿瘤模型 三维能量多普勒超声 卵巢肿瘤 超声检查 

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]