经阴道彩色多普勒能量图对妇科恶性肿瘤术后监测的价值

背景与目的:经阴道超声检查(transvaginalultrasonography,TVS)和彩色多普勒能量图(colordopplerenergyimaging,CDE)已广泛应用于超声诊断,但有关TVS-CDE在妇科恶性肿瘤术后监测中运用的文献报道甚少,本研究探讨TVS-CDE对妇科恶性肿瘤术后监测的价值。方法:对54例临床疑盆腔恶性肿瘤复发的患者行经腹部超声(transabdominalultrasonography,TAS)、TVS和TVS-CDE检查,将检查结果与病理组织学诊断对照,分别计算三种检查方法的敏感性、特异性、准确率,并将准确率行两两比较的χ2检验。结果:TAS诊断43例为复发肿瘤;TVS诊断46例为复发肿瘤,且能直观地观察复发病灶的位置、大小、形态及与周围组织器官的关系;TVS-CDE诊断47例为复发肿瘤,不仅能获得TVS的诊断信息,还能够准确地显示肿块的血流分布情况。TAS、TVS及TVS-CDE的敏感性分别为81.3%、91.7%和95.9%;特异性分别为33.3%、66.7%和83.3%;准确率分别为75.9%、88.9%和94.4%。TVS、TVS-CDE的准确率均较TAS高,有统计学意义(P<0.05);TVS准确率与TVS-CDE准确率比较无统计学意义(P>0.05)。结论:TVS在妇科恶性肿块的准确诊断中有重要的价值,结合CDE能更有效地发现盆腔内复发病灶。

Evaluation of transvaginal ultrasonography-color Doppler energy imaging in surveillance of gynecologic malignant tumors after operation

BACKGROUND &OBJECTIVE: Transvaginal ultrasonography (TVS) and color Doppler energy imaging (CDE) have been already applied in ultrasonography diagnosis extensively, but articles about the methods in surveillance of gynecologic malignant tumors after operation are few. The objective of this study was to evaluate TVS CDE in surveillance of gynecologic malignant tumors after operation. METHODS: Fifty four cases of gynecologic malignant tumors after operation, which were doubted as recurrent malignant tumors in clinic, were scanned with transabdominal ultrasonography (TAS), TVS, and TVS CDE. The results were compared with that of pathology. Then their sensitivity,specificity,and accuracy were calculated, and the accuracy was compared by Chi square test. RESULTS: Forty three cases were diagnosed as malignant tumors by TAS; Forty six cases were diagnosed as malignant tumors by TVS,and the positions,sizes,characteristics of the recurrent malignant tumors could be depicted visually. Forty seven cases were diagnosed as malignant tumors by TVS CDE;Not only the blood flow characteristics of masses,but also more diagnostic information than TVS were provided. The sensitivity was 81.3%, 91.7%,and 95.9%,respectively;the specificity was 33.3%,66.7%,and 83.3%,respectively;the accuracy was 75.9%,88.9%,and 94.4%,respectively. Obviously, the accuracy of both TVS and TVS CDE was higher than that of TAS(P< 0.05), but the accuracy of TVS and TVS CDE was similar (P >0.05). CONCLUSION: TVS CDE is helpful in the diagnosis of gynecologic malignant masses. It will be more effective in surveillance of recurrent gynecologic malignant tumors if it combined with CDE.