Prömpeler H J, Madjar H, Sauerbrei W, Lattermann U, Pfleiderer A
Department of Obstetrics and Gynecology, University of Freiburg, Germany.
Institute for Medical Biometry and Informatics, University of Freiburg, Germany.
Ultrasound Obstet Gynecol. 1994 Sep 1;4(5):406-413. doi: 10.1046/j.1469-0705.1994.04050406.x.
Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumors in postmenopausal patients. An ATL UM9/HDI was used. The following flow criteria were analyzed: lowest resistance index (RI) and pulsatility index (PI), total number of arteries and number of central arteries and the maximum, mean and sum of systolic, end-diastolic and time-averaged maximum velocities of all intratumoral vessels. In 98% of malignant and in 85% of benign lesions, vessels were detected. All flow criteria showed highly significant differences between benign and malignant tumors (p < 0.0001). However, there was a considerable overlap between benign and malignant tumors (e.g. the median of the lowest RI was 0.62 (range 0.26-1.0) for benign and 0.40 (0.22-0.66) for malignant tumors; the median of the maximum systolic velocity was 17.5 cm/s (range 5.2-61.5 cm/s) for benign and 47.05 cm/s (14.6-105.0 cm/s) for malignant tumors). Differentiation of malignant tumors by the lowest RI and PI, number of arteries and maximum of systolic flow velocities gave a sensitivity of 77-85%, specificity of 77-83% and accuracy of 80-84%. Differentiation was superior by calculation of the maximum end-diastolic velocities and by the summation of the systolic, end-diastolic and time-averaged maximum flow velocities: sensitivity 90-9.5% specificity 83-86% and accuracy 87-91%. This study confirms that a single measurement is not sufficient for an accurate differentiation of ovarian lesions and, besides the measurement of minimum RI and PI, the measurements of flow velocities as Doppler criteria play an important role.
对83例绝经后患者的卵巢肿瘤（42例良性，41例恶性）进行了彩色多普勒和双功超声测量。使用的是ATL UM9/HDI。分析了以下血流标准：最低阻力指数（RI）和搏动指数（PI）、动脉总数、中央动脉数量以及所有肿瘤内血管的收缩期、舒张末期和时间平均最大速度的最大值、平均值和总和。在98%的恶性病变和85%的良性病变中检测到血管。所有血流标准在良性和恶性肿瘤之间均显示出高度显著差异（p < 0.0001）。然而，良性和恶性肿瘤之间存在相当大的重叠（例如，最低RI的中位数，良性肿瘤为0.62（范围0.26 - 1.0），恶性肿瘤为0.40（0.22 - 0.66）；收缩期最大速度的中位数，良性肿瘤为17.5 cm/s（范围5.2 - 61.5 cm/s），恶性肿瘤为47.05 cm/s（14.6 - 105.0 cm/s））。通过最低RI和PI、动脉数量以及收缩期血流速度最大值对恶性肿瘤进行鉴别，敏感性为77 - 85%，特异性为77 - 83%，准确性为80 - 84%。通过计算舒张末期最大速度以及收缩期、舒张末期和时间平均最大血流速度的总和进行鉴别效果更佳：敏感性90 - 95%，特异性83 - 86%，准确性87 - 91%。本研究证实，单次测量不足以准确鉴别卵巢病变，除了测量最低RI和PI外，作为多普勒标准的血流速度测量也起着重要作用。
