增强CT、超声联合检测对术前鉴别卵巢病变良恶性的价值及影像特点分析
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摘要
目的分析增强CT、超声联合检测在术前鉴别卵巢病变良恶性中的价值及影像特点。方法回顾性分析我院2014年3月-2017年8月间收治的300例卵巢病变患者影像学资料,以病理检查结果为标准,评估增强CT联合超声检测在鉴别卵巢病变良恶性中的价值。结果病理检查结果提示,300例卵巢肿瘤患者中有81例为恶性肿瘤,219例为良性肿瘤,81例恶性肿瘤患者中单侧病灶53例,双侧病灶28例;伴淋巴结转移者23例,侵犯周围组织脏器者41例;CT诊断灵敏度为87.21%、特异度为81.48%、准确度为85.67%,CT检查能有效定位病灶位置、检测病灶密度,提示病灶内部结构与形态特征,且病灶转移等征象明显,恶性病变在增强扫描时囊壁及间隔明显强化,实性成分不均匀强化;超声诊断灵敏度为93.15%、特异度为92.59%、准确度为93.00%,超声检查方式多样,能有效显示病灶形态、结构、内部血流信号等特征;增强CT联合超声检查灵敏度为96.35%、特异度为97.53%、准确度为96.67%。结论增强CT联合超声检查可弥补单纯检查的不足,有效提高卵巢肿瘤良恶性诊断效果,值得临床推广。
Objective To analyze the value and imaging features of enhanced CT combined with ultrasound in the preoperative identification of benign and malignant ovarian lesions. Methods The imaging data of 300 patients with ovarian lesions admitted to our hospital from March 2014 to August 2017 were analyzed retrospectively. The results of pathological examination were taken as criterion to evaluate the value of enhanced CT combined with ultrasound in the identification of benign and malignant ovarian lesions.Results Pathological examination results showed that there were 81 cases of malignant tumors and 219 cases of benign tumors among 300 patients with ovarian tumors, and there were 53 cases of unilateral lesions and 28 cases of bilateral lesions among 81 patients with malignant tumors. There were 23 cases patients with lymph node metastasis and41 cases with invasion of surrounding organs. The diagnostic sensitivity, specificity and accuracy of CT were 87.21%, 81.48% and 85.67%, and CT examination could effectively diagnose the lesion location, detect the lesion density, suggest the internal structure and morphological characteristics of lesion, and metastasis, and had obvious signs of lesion metastasis. And malignant lesions were with obvious enhancement in capsule wall and interval, and unevenly enhanced solid components during enhanced scan. The sensitivity,specificity and accuracy of ultrasound were 93.15%, 92.59% and 93.00%, respectively. The ultrasonic examination methods were various and could effectively show the features of lesion morphology, structure and internal blood flow signal. The sensitivity, specificity and accuracy of enhanced CT combined with ultrasound were 96.35%, 97.53% and 96.67%,respectively. Conclusion Enhanced CT combined with ultrasound can increase the deficiency of simple examination, and effectively improve the diagnostic effects of benign and malignant ovarian tumors, thus it is worthy of clinical promotion.
Objective To analyze the value and imaging features of enhanced CT combined with ultrasound in the preoperative identification of benign and malignant ovarian lesions. Methods The imaging data of 300 patients with ovarian lesions admitted to our hospital from March 2014 to August 2017 were analyzed retrospectively. The results of pathological examination were taken as criterion to evaluate the value of enhanced CT combined with ultrasound in the identification of benign and malignant ovarian lesions.Results Pathological examination results showed that there were 81 cases of malignant tumors and 219 cases of benign tumors among 300 patients with ovarian tumors, and there were 53 cases of unilateral lesions and 28 cases of bilateral lesions among 81 patients with malignant tumors. There were 23 cases patients with lymph node metastasis and41 cases with invasion of surrounding organs. The diagnostic sensitivity, specificity and accuracy of CT were 87.21%, 81.48% and 85.67%, and CT examination could effectively diagnose the lesion location, detect the lesion density, suggest the internal structure and morphological characteristics of lesion, and metastasis, and had obvious signs of lesion metastasis. And malignant lesions were with obvious enhancement in capsule wall and interval, and unevenly enhanced solid components during enhanced scan. The sensitivity,specificity and accuracy of ultrasound were 93.15%, 92.59% and 93.00%, respectively. The ultrasonic examination methods were various and could effectively show the features of lesion morphology, structure and internal blood flow signal. The sensitivity, specificity and accuracy of enhanced CT combined with ultrasound were 96.35%, 97.53% and 96.67%,respectively. Conclusion Enhanced CT combined with ultrasound can increase the deficiency of simple examination, and effectively improve the diagnostic effects of benign and malignant ovarian tumors, thus it is worthy of clinical promotion.
引文
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[10]王乐华,黄旴宁,刘艳婷,张亚庆.经阴道彩超联合血清CA 1 2 5、C E A检测对卵巢癌诊断灵敏度及准确率[J].中国地方病防治杂志,2017,32(7):793-795.
[11]何海洋,凌开建,阎萍,李宇迪,梁志清.CA125/HE4和超声影像指标在不同类型盆腔包块的分布特征及恶性风险中的评估价值[J].现代妇产科进展,2018,27(1):23-27.
[12]李载红,景香香,陈银,等.彩超联合血清CA125、CA724对卵巢良恶性肿瘤鉴别诊断的意义[J].中国临床医学影像杂志,2016,27(6):416-418.
[2]李磊,赵永民,高新萍.超声、CT、MRI和血清CA125对卵巢癌诊断的对比分析[J].河北医科大学学报,2017,38(3):349-352.
[3]王丽华,陈福美,仲艳密,等.超声联合血清CA125对卵巢癌的诊断价值分析[J].中国临床医学影像杂志,2018,29(2):144-145.
[4]智生芳,毕伟,黄晓红,李霞霞,张伟标.F-FDG PET/CT对卵巢癌患者术后复发、转移的诊断敏感性及准确性研究[J].中国CT和MRI杂志,2016,14(2):100-102.
[5]毛卫霞,王永宏.卵巢癌的CT MRI诊断价值比较[J].河北医学,2017,23(11):1795-1798.
[6]包杰,闫昆,胡碧波,等.全腹多层螺旋CT扫描对卵巢癌分期术前评价中的价值[J].中华内分泌外科杂志,2016,10(1):63-66.
[7]王海燕,袁肖娜,周娣,等.卵巢癌肝周转移灶的CT特征分析[J].医学影像学杂志,2016,26(10):1876-1880.
[8]向莉娟,宋丽君,周德伟.CT、MRI对鉴别Ⅰ、Ⅱ型上皮性卵巢癌的应用价值[J].实用癌症杂志,2018,33(4):641-643.
[9]朱朝选.核磁共振联合超声成像在原发性小卵巢癌诊断中的应用研究[J].中国CT和MRI杂志,2017,15(7):113-116.
[10]王乐华,黄旴宁,刘艳婷,张亚庆.经阴道彩超联合血清CA 1 2 5、C E A检测对卵巢癌诊断灵敏度及准确率[J].中国地方病防治杂志,2017,32(7):793-795.
[11]何海洋,凌开建,阎萍,李宇迪,梁志清.CA125/HE4和超声影像指标在不同类型盆腔包块的分布特征及恶性风险中的评估价值[J].现代妇产科进展,2018,27(1):23-27.
[12]李载红,景香香,陈银,等.彩超联合血清CA125、CA724对卵巢良恶性肿瘤鉴别诊断的意义[J].中国临床医学影像杂志,2016,27(6):416-418.