实时三维超声在诊断恶性肿瘤腹腔转移中的应用价值

背景与目的：常规血液生化、腹水检查和以往的影像学检查诊断恶性肿瘤腹腔转移的敏感性低，剖腹探查术又不适用于终末期患者。实时三维超声技术是近年发展起来的诊断腹腔疾病的新技术。本研究旨在探讨实时三维超声在恶性肿瘤腹腔转移诊断中的应用价值。方法：本文对28例临床诊断为恶性肿瘤需要开腹手术患者术前分别应用二维及实时三维超声检查腹腔情况，并将检查结果与手术及病理结果相对照。以检出腹腔包块、腹腔淋巴结肿大、腹膜增厚、腹腔脏器及腹膜表面结节等任一征象即可诊断为腹腔转移。结果：28例恶性肿瘤患者，经手术证实，实际发生腹腔转移25例，二维及实时三维超声诊断正确率为42．86％、92．86％，灵敏度为37．5％、95．83％，特异度为75．0％、75．0％。二维及实时三维超声方法对腹腔转移结节的检出率分别为16％、96％。对恶性肿瘤腹腔转移，两种方法差异有显著性（P〈0．001）。结论：实时三维超声在恶性肿瘤腹腔转移诊断中具有重要的临床意义，对腹腔转移结节的检出结果证实，实时三维超声在诊断恶性肿瘤腹腔转移方面具有明显的优势，值得临床医生重视及应用。

Application of real-time three-dimensional ultrasound in the diagnosis of abdominal cavity metastasis of malignant tumor

Background and purpose: Blood biochemistry, ascites test and imaging diagnosis have low sensitivity for the diagnosis of abdominal neoplasma. And also exploratory laparotomy is not suitable for late stage patients. Real-time three-dimensional(3D) ultrasound is a new method in the diagnosis of celiac disease. We aimed to explore the application of this new tool in the diagnosis of abdominal cavity metastases of malignant tumor. Methods: Twenty-eight patients with malignant tumor preoperatively underwent both 2D and real-time 3D ultrasound examination The results were compared to pathological and clinical outcomes. Any one of those signs such as abdominal cavity mass, abdominal cavity lymphadenectasis, thickening of the peritoneum, nodules over the peritoneal and abdominal organs surface were considered as abdominal cavity metastases. Results: Twenty-five of them were pathologically confirmed to have abdominal cavity metastases. The diagnosis correlation rate of 2D and real-time 3D in the diagnosis of abdominal cavity metastases of malignant tumor were 42.86% and 92.86%, respectively. The sensitivity of these two methods was 37.5% and 95.83%, respectively. The speificity of two methods was 75.0%. The detection rates of the two methods were 16% and 96%, respectively. There were highly significant differences between two groups (P<0.001).Conclusion: Real-time 3D ultrasound had more value in the diagnosis of abdominal cavity metastases of malignant tumor in terms of sensitivity, specificity and positive detection.