Diagnostic value of hemodynamics under ultrasound for benign and malignant ovarian and uterine tumors
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摘要:
目的 利用超声血流动力学观察女性盆腔主要脏器卵巢、子宫供血动脉血流情况，为临床诊断卵巢及子宫良、恶性肿瘤提供血流动力学诊断依据。 方法 选取从2017年1月~2018年1月在我院就诊的女性卵巢和子宫肿瘤患者，各50例，所有患者最终均手术或者腹腔镜获取标本，证实病理类型，分为4个亚组：A组为卵巢良性肿瘤；B组为卵巢恶性肿瘤；C组为子宫良性肿瘤；D组为子宫恶性肿瘤，每组25例，采用高频超声，明确肿瘤超声下血流形态分级，卵巢动脉和子宫动脉的阻力指数和搏动指数，采用ROC曲线分析超声血流动力学对卵巢癌和子宫癌诊断的敏感度和特异度差异。 结果 卵巢和子宫良性肿瘤阻力指数、搏动指数高于恶性肿瘤（P<0.05），卵巢和子宫良性肿瘤内部血流信号和周边血流信号检出率与卵巢和子宫恶性肿瘤存在明显差异（P<0.05），阴道超声多普勒诊断卵巢癌敏感度为76.21%，特异度为80.21%。阴道超声多普勒诊断子宫癌敏感度为73.36%，特异度为76.72%。 结论 彩色多普勒超声通过血流动力学参数可实现早期筛查卵巢癌和子宫癌，具有重要临床应用价值。 Abstract:Objective To observe the blood supply artery of uterus and ovary in female pelvic organs by ultrasonic kinetics, and to provide the basis of hemodynamic for clinical diagnosis of good and malignant ovaran and uterine tumor. Methods From January 2017 to January 2018, 50 women with ovarian and uterine tumors were selected. All patients underwent surgery or laparoscopic specimens to confirm the pathological type. They were divided into four subgroups: group A was benign ovarian tumors; Group B is malignant ovarian tumors; Group C is uterine benign tumors; Group D is uterine malignant tumors, 25 cases in each group.High-frequency ultrasound was used to determine the morphological classification of blood flow under ultrasound, the resistance index and pulsation index of ovarian artery and uterine artery, and the specificity and sensitivity difference of ultrasound hemodynamics in the diagnosis of ovarian and uterine malignant lesions were analyzed by ROC curve. Results The ovarian and uterine benign tumors resistance index and pulsatility index were higher than malignant tumors (P<0.05). The internal signal and peripheral signal detection rate of ovarian and uterine benign tumors were significantly different from those of ovarian and uterine malignant tumor s (P<0.05). The sensitivity of Vaginal ultrasound Doppler diagnosis for ovarian cancer was 76.21%, and the specificity was 80.21%. The sensitivity of vaginal ultrasound Doppler diagnosis for uterine cancer was 73.36%, and the specificity was 76.72%. Conclusion Color Doppler ultrasound can achieve early screening for malignant ovarian cancer and malignant uterine cancer through hemodynamic parameters, which has important clinical value. -
Key words:
- color Doppler ultrasound /
- hemodynamics /
- ovarian cancer /
- uterine cancer
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图 1 卵巢囊腺瘤
A: 卵巢囊腺瘤血流频谱图，呈高阻高搏改变，阻力指数0.65, 搏动指数1.19; B: 卵巢囊腺瘤血流图, 血流形态分Ⅰ级, 肿瘤周边见点状血流, 内部未见血流信号.
图 4 子宫颈癌
A: 宫颈癌血流频谱图，显示低阻低搏改变, 阻力指数为0.43, 搏动指数为0.63; B宫颈癌血流图, 表现血流形态为Ⅲ级, 周边及内部可见丰富的短条状血流信号.
图 3 子宫肌瘤
A: 子宫肌瘤血流频谱图, 显示高阻高搏改变, 阻力指数为0.64, 搏动指数为1.35; B: 子宫肌瘤血流图, 血流形态为Ⅰ级, 表现为周边可见散在点状血流信号, 肿瘤内部未见血流信号.
表 1 卵巢良性肿瘤与恶性肿瘤各血流参数定量比较（Mean±SD）
组别 阻力指数 搏动指数 A组 0.71±0.21 1.24±0.46 B组 0.31±0.11 0.64±0.18 t 5.718 6.973 P 0.000 0.000 
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表 2 子宫良性肿瘤与恶性肿瘤各血流参数定量比较（Mean±SD）
组别 阻力指数 搏动指数 C组 0.89±0.36 1.42±0.62 D组 0.35±0.11 0.72±0.32 t 5.892 6.152 P 0.000 0.000
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