肿瘤内血流检测对卵巢肿瘤定性诊断的研究

目的：评价多普勒血流显象技术检测卵巢肿瘤内血流定性诊断卵巢肿瘤的价值。方法：对疑诊卵巢肿瘤的75例（其中53例卵巢良性肿瘤和22例恶性肿瘤）于术前1w内行C超检查及肿瘤内血流检测，并与术后组织病理学诊断对照。结果：53例卵巢良性肿瘤中的21例（39．62％）及22例卵巢恶性肿瘤中的21例（95．45％）C超均显示其结构鼻常；在21例卵巢良性肿瘤内检测到血流高峰收缩速度（PSV）的均值为14．2±8．1cm／s，阻抗指数（RI）均值为0．478±0．119。当以PSV＝16cm／s为卵巢良、恶性肿瘤的界值时，PSV诊断卵巢恶性肿瘤的敏感性和特异性率分别为90．91％和90．57％；当以RI＝0．72为卵巢良、恶性肿瘤的界值时，RI诊断卵巢恶性肿瘤的敏感性和特异性率分别为86．36％和69．81％；C超诊断卵巢恶性肿瘤的敏感性和特异性率分别为95．45％和71．70％。三者的敏感性差异无显著性，而PSV诊断卵巢恶性肿瘤的特异性率明显高于RI和C超检查者，差异具有显著性（P＜0．05）。结论：用多普勒血流显象技术检测卵巢肿瘤内异常。流的PSV，对预测卵巢肿瘤性质具有一定的临床意义。

Study on the qualitative diagnosis of ovarian tumors by examination of intratumor blood flow.

To evaluate on the qualitative diagnosis of ovarian tumors by examination of intratumor blood flow with Doppler ultrasonography and C ultrasound.Methods: 75 cases of ovarian tumors(53 benign cases, 22 malignant cases)were detected for intratumor blood flow velocity with C ultrasound and Doppler flow imaging technique,and contrasted to histopathological diagnosis. Results: 21 in 53 cases of benign tumors(39. 62 % )and 21 in cases of maligant tumors(95. 45 % )had abnormal morphologic features suggesting malignant abnormal morphologic features. In benign tumors, the average value of peak systolic velocity(PSV) was detected 14. 2± 8. 1cm/s and the resistance index (RI) was 0.478 ± 0. 119. In malignant tumors, the average value of PSV was 24. 2±11. 5cm/s and the RI was 0. 478±0. 119. When considering the cutoff value of PSV= 1 6cm/s and cutoff value RI= 0. 72 for differentiation of benign and malignant tumors, the sensitivie and specifitive rates of PSV in detecting malignant tumors were 90. 91 % and 90. 57%, respectively; and the sensitive and specifitive rates of RI in malignant tumors were 86. 46% and 69. 81 %,respectively ; and those using C-mode ultrasound were 95. 45 % and 71. 70 %;There were no singnificant difference in sensitivity among PSV, RI and C ultrasound. Howerver, the specificity of PSV was significantly higher than those of RI and C-mode ultrasound (P< 0.05 ). Conclusion: These results suggest that PSV obtainted from intratumor abnomal morphologic features by using Doppler ultrasonography may provide as a superior means for differentiating malignant from benign ovarian tumors.