术前诊断卵巢交界性肿瘤的超声特征

目的探讨卵巢交界性肿瘤的术前超声特点，以便早期诊断。方法总结分析1995年10月-2005年12月，在我院住院手术的卵巢交界性肿瘤患者，术前经阴道超声检查、多普勒血流频谱检测，手术病理证实为交界性卵巢肿瘤的患者共54例，年龄18-82岁。同时与同期手术的卵巢良性上皮性肿瘤60例、I期卵巢癌22例做对比。结果54例卵巢交界性肿瘤中，浆液性19例，黏液性28例，混合型7例。其中浆液性肿瘤与黏液性肿瘤相比，肿瘤体积小（P=0．003）、单房多见（P〈0．001）、其内多有乳头与实性区（P〈0．001）。54例卵巢交界性肿瘤中，29／54（53．70％）例内壁有乳头或实性区，良性肿瘤7／60（11．67％）例内壁有乳头或实性区，I期卵巢癌20／22（90．91％）例内壁有乳头或实性区（P〈0．001）。50例交界性肿瘤行彩色多普勒检查，45／50（90．00％）例可探测到血流信号（与良性肿瘤相比P〈0．001；与I期卵巢癌相比P=0．297），其中29例阻力指数〈0．50。结论经阴道超声检查发现卵巢囊性肿物内出现乳头状突起、实性区或密集房隔、房隔增厚时应警惕有可能为交界性肿瘤，如联合多普勒血流频谱检测肿瘤阻力指数〈0．50更有助于术前诊断。

Preoperative sonographic features of borderline tumors of the ovary

Objective To analyze ultrasonographic characteristics of ovarian tumors of borderline malignancy. Methods We performed a retrospective analysis on ultrasonographic parameters in 54 patients aged from 18 to 82 with borderline ovarian tumors, who were diagnosed pathologically in our hospital from October 1995 to December 2005, as well as 60 benign cysts and 22 malignant tumors of the ovary during the same period. Results Of the 54 borderline cases, 19 were serous, 28 mucinous and 7 mixture cystadenomas. Serous tumors tended to be smaller in size (P=0.003), less multilocular (P<0.001), and more presented with solid part or papillary (P<0.001) than mucinous tumors. Twenty-nine out of the 54 (53.70%) borderline malignancy contained papillary or solid patterns, while 7/60 (11.67%) in benign cysts and 20/22 (90.91%) in malignant tumors (P<0.001). Fifty ovarian tumors of borderline malignancy were examined by color Doppler ultrasound. And 45/50 (90.00%) cases showed blood flow; the resistance index (RI) <0.5 was found in 29/50 (58%). Conclusion When a cystic mass has papillae or solid pattern, multiple or thick septa, or color Doppler imaging shows low RI<0.50 within the mass, a borderline cystic tumor should be suspected.