三维血管超声造影在卵巢肿块良恶性预测中的应用。

Three-dimensional angioultrasonography for the prediction of malignancy in ovarian masses.

机构信息

Obstetrics and Gynaecology Department, Autónoma University of Madrid, Hospital Universitario Puerta de Hierro, Madrid, Spain.

出版信息

Gynecol Obstet Invest. 2013;75(2):120-5. doi: 10.1159/000345576. Epub 2013 Jan 19.

DOI:10.1159/000345576

PMID:23343889

Abstract

OBJECTIVE

To determine the efficacy of the angiographic indexes of 3D power Doppler angiography (3D-PDA) for the diagnosis of malignancy in complex ovarian masses.

METHODS

A prospective, observational study of 72 patients with complex adnexal mass.

RESULTS

In the morphological study, 3D ultrasound showed sensitivity, specificity, PPV, NPV, PLHR and NLHR of 84.6%, 81.9%, 85.1%, 81.8%, 4.65 and 0.19. No differences in vascular indexes (VI, FI, VFI) between malignant and benign masses were found: VI 5.38 (CI 95% 3.06-7.7) vs. 6.29 (CI 95% 4.41-8.17) (p = 0.53); FI 29.6 (CI 95% 25.17-34.08) vs. 33.8 (CI 95% 30.03-37.3) (p = 0.15); VFI 1.68 (CI 95% 0.94-2.42) vs. 2.37 (CI 95% 1.49-3.25) (p = 0.24). When analysed according to different stages, VI was higher in patients with more advanced stages of disease; 4.34 (95% CI 2.21-6.47) vs. 7.38 (95% CI 4.7-10.06) (p = 0.11). FI was significantly lower in patients with early stages of disease; FI 29.07 (95% CI 21.49-36.68) vs. 36.46 (95% CI 32.31-40.62) (p = 0.04). For VFI, differences were not significant, although there was a strong trend; VFI 1.47 (95% CI 0.67-2.28) vs. 2.86 (95% CI 1.57-4.16) (p = 0.11). 3D-PDA indexes were significantly higher in patients with positive adenopathies.

CONCLUSION

3D-PDA values increase progressively, but not significantly, with the stage of the disease.

摘要

目的

确定三维能量多普勒血管造影（3D-PDA）的血管造影指数对复杂卵巢肿块恶性肿瘤的诊断价值。

方法

对 72 例复杂附件肿块患者进行前瞻性、观察性研究。

结果

在形态学研究中，3D 超声显示敏感性、特异性、PPV、NPV、PLHR 和 NLHR 分别为 84.6%、81.9%、85.1%、81.8%、4.65 和 0.19。恶性和良性肿块之间的血管指数（VI、FI、VFI）无差异：VI 5.38（95%CI 95%3.06-7.7）与 6.29（95%CI 95%4.41-8.17）（p=0.53）；FI 29.6（95%CI 95%25.17-34.08）与 33.8（95%CI 95%30.03-37.3）（p=0.15）；VFI 1.68（95%CI 95%0.94-2.42）与 2.37（95%CI 95%1.49-3.25）（p=0.24）。按不同分期分析时，疾病分期较高的患者 VI 较高；4.34（95%CI 2.21-6.47）与 7.38（95%CI 4.7-10.06）（p=0.11）。FI 在疾病早期阶段明显较低；FI 29.07（95%CI 21.49-36.68）与 36.46（95%CI 32.31-40.62）（p=0.04）。对于 VFI，差异虽不显著，但有明显趋势；VFI 1.47（95%CI 0.67-2.28）与 2.86（95%CI 1.57-4.16）（p=0.11）。3D-PDA 指数在有阳性淋巴结病的患者中显著升高。