Guerriero Stefano, Ajossa Silvia, Mais Valerio, Angiolucci Marco, Paoletti Anna Maria, Melis Gian Benedetto
Department of Obstetrics and Gynecology, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124, Italy.
J Ultrasound Med. 2004 Sep;23(9):1193-200. doi: 10.7863/jum.2004.23.9.1193.
The aim of this prospective study was to investigate the accuracy of B-mode transvaginal sonography alone and combined with color Doppler imaging and cancer antigen 125 (CA 125) plasma concentrations in differentiating peritoneal cysts from other adnexal masses.
Between September 1999 and September 2003, 213 adnexal masses underwent transvaginal sonography combined with power Doppler evaluation. Plasma concentrations of CA 125 were measured before surgery. The sonographic suspicion of peritoneal cysts (the presence of a bizarre lump-shaped cyst with a thin wall and fine internal septations with or without an ovary suspended among adhesions) was then compared with the surgical diagnosis. The overall agreement between the sonographic test results and the surgical findings was calculated by the kappa index. The diagnostic value of each test was also evaluated with likelihood ratios (LRs).
Thirteen of 213 patients were found to have peritoneal cysts. Specificity and sensitivity of B-mode sonography for differentiating peritoneal cysts from other adnexal masses were 96% (95% confidence interval, 94%-97%) and 62% (95% confidence interval, 35%-83%), respectively. The value of the negative LR (0.40) indicated a good clinical test, whereas the positive LR (15) indicated an excellent test. Power Doppler imaging did not seem to increase the accuracy of B-mode transvaginal sonography (kappa = 0.51 and 0.52, respectively), nor did the association of CA 125 plasma concentration (kappa = 0.34).
Transvaginal sonography alone is a useful method for detection of peritoneal cysts.
本前瞻性研究旨在探讨单纯B型经阴道超声检查以及联合彩色多普勒成像和癌抗原125（CA 125）血浆浓度在鉴别腹膜囊肿与其他附件肿块方面的准确性。
1999年9月至2003年9月期间，对213例附件肿块进行了经阴道超声检查并结合能量多普勒评估。术前测量CA 125的血浆浓度。然后将超声检查怀疑为腹膜囊肿（存在壁薄、内部有细隔的奇异肿块状囊肿，有或没有粘连间悬垂的卵巢）与手术诊断结果进行比较。超声检查结果与手术发现之间的总体一致性通过kappa指数计算。每项检查的诊断价值也用似然比（LRs）进行评估。
213例患者中有13例被发现患有腹膜囊肿。B型超声检查鉴别腹膜囊肿与其他附件肿块的特异性和敏感性分别为96%（95%置信区间，94% - 97%）和62%（95%置信区间，35% - 83%）。阴性似然比（0.40）表明该临床检查良好，而阳性似然比（15）表明该检查优秀。能量多普勒成像似乎并未提高B型经阴道超声检查的准确性（kappa分别为0.51和0.52），CA 125血浆浓度联合检查也未提高准确性（kappa = 0.34）。
单纯经阴道超声检查是检测腹膜囊肿的一种有用方法。
