Asayama Yoshiki, Yoshimitsu Kengo, Aibe Hitoshi, Nishie Akihiro, Kakihira Daisuke, Irie Hiroyuki, Tajima Tsuyoshi, Matake Kunishige, Nakayama Tomohiro, Ohishi Yoshihiro, Kaneki Eisuke, Honda Hiroshi
Department of Clinical Radiology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
AJR Am J Roentgenol. 2006 Feb;186(2):440-8. doi: 10.2214/AJR.04.1417.
The objective of our study was to determine the usefulness of recognizing the continuity of the gonadal veins to the pelvic mass to differentiate ovarian versus uterine origin on MDCT in females with a large pelvic mass.
Two radiologists interpreted the MDCT images obtained on a monitor, using paging methods, in 86 female patients with a large pelvic mass (> 8 cm) and 40 patients without an abdominopelvic mass as control subjects. The following issues were recorded using a 5-point scale: visualization of gonadal veins and origin determination based on anatomic continuity. Receiver operating characteristic (ROC) curve analysis was performed, and the interobserver differences were checked with kappa statistics. The maximum diameters of the gonadal veins were also measured. With consensus interpretations, the sensitivity, specificity, and accuracy of ovarian origin determination were calculated.
Gonadal veins were shown in more than 70% of the subjects in both the control group and the patients with a mass (hereafter referred to as the "mass group"). There was no significant difference in the diameter of the gonadal veins between the control and mass groups and between patients with an ovarian mass and those with a uterine mass. The values for the area under the ROC curve (A(z)) of the two observers for ovarian origin determination were 0.90 and 0.92. The kappa value was 0.48. The sensitivity, specificity, and accuracy were 83.3%, 87.5%, and 84.9%, respectively.
Gonadal veins can be shown on MDCT with high consistency; MDCT provides useful information for determining the origin of relatively large pelvic tumors arising in females.
我们研究的目的是确定在多层螺旋CT（MDCT）上识别性腺静脉与盆腔肿块的连续性对于鉴别女性盆腔大肿块的卵巢来源与子宫来源的有用性。
两名放射科医生使用分页方法在监视器上解读86例盆腔大肿块（>8 cm）女性患者以及40例无腹盆腔肿块的患者（作为对照）的MDCT图像。使用5分制记录以下问题：性腺静脉的可视化以及基于解剖连续性的起源判定。进行受试者操作特征（ROC）曲线分析，并用kappa统计量检查观察者间差异。还测量了性腺静脉的最大直径。经一致解读后，计算卵巢起源判定的敏感性、特异性和准确性。
对照组和有肿块的患者（以下简称“肿块组”）中均有超过70%的受试者显示出性腺静脉。对照组与肿块组之间以及卵巢肿块患者与子宫肿块患者之间性腺静脉直径无显著差异。两名观察者判定卵巢起源的ROC曲线下面积（A(z)）值分别为0.90和0.92。kappa值为0.48。敏感性、特异性和准确性分别为83.3%、87.5%和84.9%。
MDCT上性腺静脉的显示具有高度一致性；MDCT为确定女性盆腔相对较大肿瘤的起源提供了有用信息。
