超声检查在卵巢浆液性腺癌、黏液性囊腺癌中的鉴别诊断价值

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[目的]探讨超声检查在卵巢浆液性腺癌、黏液性囊腺癌中的鉴别诊断价值.[方法]回顾性分析2012年4月至2016年12月在本院妇产科手术治疗的58例卵巢恶性肿瘤患者的术前超声检查资料,其中卵巢浆液性囊腺癌40例、黏液性囊腺癌18例,以术后病理诊断为金标准,通过对比术前超声及彩色多普勒血流信号图像,分析超声术前检查在卵巢浆液性腺癌、黏液性囊腺癌中的应用价值.[结果]浆液性囊腺癌的肿瘤最大径大于黏液性囊腺癌(P<0.05),浆液性囊腺癌的囊内隔增厚、乳头状实质性肿块检出率高于黏液性囊腺癌(P<0.05),浆液性囊腺癌的内部高回声斑块检出率低于黏液性囊性癌(P<0.05);浆液性囊腺癌与黏液性囊腺癌的卵巢动脉平均收缩期最高峰值血流速度(A)、舒张期最低峰值血流速度(B)、搏动指数(PI)值比较差异均无统计学意义(P>0.05),浆液性囊腺癌的卵巢动脉阻力指数(RI)高于黏液性囊腺癌(P<0.05);术前超声检查鉴别诊断浆液性囊腺癌与黏液性囊腺癌的灵敏度为70.00%、特异度为66.67%、漏诊率为30.00%、误诊率为33.33%、阳性预测值为82.35%、阴性预测值为50.00%.[结论]术前超声检查对于鉴别诊断卵巢浆液性囊腺癌与黏液性囊腺癌具有一定的参考价值,但是灵敏性和特异性不高,可作为临床病理检查前的一种辅助检查手段.“,”[Objective] To study the application value of color Doppler ultrasound on the differential diagnosis of ovarian serous cystadenocarcinoma and mucinous cystadenocarcinoma in a clinical setting.[Methods] From April 2012 to December 2016 in the Department of Obstetrics and Gynecology of our hospital,there was a total of 58 cases of malignant ovarian tumor patients chose for the study.The patients were sorted using a preoperative ultrasonography and were retrospectively analyzed.The 58 patients included 40 cases of ovarian serous cystadenocarcinoma and 18 cases of mucinous cystadenocarcinoma.Based on pathological diagnosis of ovarian cancer,the preoperative ultrasound and color Doppler flow image signal were compared between the serous and mucinous ovarian cystadenocarcinoma in order to investigate the differential diagnosis value of ultrasound examination before the operation [Results] The maximum diameter of the serous cystadenocarcinoma was greater than that of mucinous cystadenocarcinoma (P <0.05).The cystic septum thickening and papillary solid mass detection rate in cases of serous cystadenocarcinoma were higher than those in mucinous cystadenocarcinoma(P <0.05),while the detection rate of internal hyper-echoic plaque in serous cystadenocarcinoma was lower than that of mucinous cystic carcinoma (P <0.05).The average peak value of ovarian artery systolic blood flow velocity (A),minimum diastolic peak flow velocity (B),and pulsatility index (PI) values showed no significant difference between the serous cystadenocarcinoma and mucinous cystadenocarcinoma patients (P >0.05).However,the ovarian artery resistance index (RI) of the serous cystadenocarcinoma (RI) was higher than that of mucinous cystadenocarcinoma (P <0.05).In summary,the sensitivity of preoperative ultrasonography in differential diagnosis of serous cystadenocarcinoma and mucinous cystadenocarcinoma was 70%,the specificity was 66.67 %,the missed diagnosis rate was 30%,the misdiagnosis rate was 33.33%,positive predictive value was 82.35%,and the negative predictive value was 50.00%.[Conclusion]Preoperative ultrasonography in differential diagnosis of ovarian serous cystadenocarcinoma and mucinous cystadenocarcinoma has a certain degree of value,but its true sensitivity and specificity is not high.
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