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3D-CEUS联合CT在卵巢肿块定性诊断及治疗方案指导中的应用
引用本文:李倩,贾红娥,常贝,邱云. 3D-CEUS联合CT在卵巢肿块定性诊断及治疗方案指导中的应用[J]. 中国CT和MRI杂志, 2022, 0(1)
作者姓名:李倩  贾红娥  常贝  邱云
作者单位:延安大学附属医院超声医学科;吴起县医院超声科;西安高新医院超声科
摘    要:目的探讨三维超声造影(3D-CEUS)联合电子计算机断层扫描(CT)在卵巢肿块定性诊断及治疗方案指导中的应用。方法回顾性分析2016年12月至2019年12月我院收治的80例疑似卵巢肿瘤患者临床资料,所有患者术前均行3D-CEUS及多层螺旋CT检查。以病理检查结果作为"金标准",比较3D-CEUS和多层螺旋CT分别诊断及联合诊断在良恶性卵巢肿瘤疾病中的应用价值,计算灵敏度、特异度、准确率、阴性预测值和阳性预测值,并通过测定良性肿瘤组与恶性肿瘤组在该影像学检查中的相关参数[达到时间(AT)、达峰时间(TTP)、增强强度(EI)],评估其与卵巢癌分期的相关性。结果两种检查诊断卵巢肿瘤的灵敏度、特异度、准确率以及阴性、阳性预测值差异均无统计学意义(P>0.05);3D-CEUS联合多层螺旋CT检查灵敏度、特异度、准确率、阴性和阳性预测值均明显高于单独3D-CEUS及单独多层螺旋CT检查(P<0.05);经检查,早期组、中期组及晚期组患者组间AT、TTP、EI比较均有统计学意义(P<0.05);经Spearman等级相关分析,AT、TTP与临床分期具有负相关性(r=-0.526,-0.537,P<0.05),而EI与临床分期具有正相关性(r=0.759,P<0.05)。结论3D-CEUS联合多层螺旋CT确可清晰直观地显示卵巢肿瘤患者的病灶部位及形态,临床良、恶性诊断价值较高,且术前可通过临床分期,从而有利于医师制定治疗方案。

关 键 词:三维超声造影  卵巢肿瘤  电子计算机断层扫描  诊断

Application of 3D-CEUS Combined with CT in the Qualitative Diagnosis and Treatment Regimen Guidance of Ovarian Masses
LI Qian,JIA Hong-e,CHANG Bei,QIU Yun. Application of 3D-CEUS Combined with CT in the Qualitative Diagnosis and Treatment Regimen Guidance of Ovarian Masses[J]. , 2022, 0(1)
Authors:LI Qian  JIA Hong-e  CHANG Bei  QIU Yun
Affiliation:(Department of Ultrasound Medicine,the Affiliated Hospital of Yan'an University,Yan'an 716000,shaanxi Province,China;Department of Ultrasound,Wuqi County Hospital,Yan'an 717600,shaanxi Province,China;Department of Ultrasound,Xi'an Gaoxin Hospital,Xi'an 710000,shaanxi Province,China)
Abstract:Objective To explore the application of three-dimensional contrast-enhanced ultrasonography(3D-CEUS) combined with computed tomography(CT) in the qualitative diagnosis and treatment regimen guidance of ova rian masses.Methods The clinical data of 80 patients with suspected ovarian tumors admitted to the hospital between December 2016 and December 2019 were retrospectively analyzed.All patients underwent 3D-CEUS and multi-slice spiral CT examination before surgery.Using the pathological examination results as the gold standard,the application value of single diagnosis and combined diagnosis of 3D-CEUS and multi-slice spiral CT on benign and malignant ovarian tumors was compa red,and the sensitivity,specificity,accuracy rate,negative predictive value and positive predictive value were calculated.Relevant parameters [arrival time(AT),time to peak(TTP),enhancement intensity(EI)] in imaging examination were assessed in benign tumor group and malignant tumor group to assess their correlation with ovarian cancer stages.Results There were no statistically significa nt differences in the sensitivity,specificity,accuracy rate and positive and negative predictive values by 3D-CEUS or multi-slice spiral CT in the diagnosis of ova rian tumors(all P>0.05).The sensitivity,specificity,accuracy rate and positive and negative predictive values of 3D-CEUS combined with multi-slice spiral CT were significantly higher than those of 3D-CEUS or multi-slice spiral CT(all P<0.05).After examination,there were statistically significant differences in the AT, TTP and EI among patients in early stage group,middle stage group and late stage groups(all P<0.05).After Spearman ra nk correlation analysis,AT and TTP were negatively correlated with clinical stages(r=-0.526,-0.537,all P<0.05),and EI was positively correlated with clinical stages(r=0.759,P<0.05).Conclusion 3D-CEUS combined with multi-slice spiral CT can clearly show the lesion location and morphology of patients with ovarian tumors,and it has high clinical value of benign and malignant diagnosis,and it is helpful for physicians to formulate treatment regimens through postoperative clinical staging.
Keywords:Three-Dimensional Contrast-Enhanced Ultrasonography  Ovarian Tumors  Computed Tomography  Diagnosis
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