Zhi Mingchun, Wang Miaoqian, Li Wei, Ma Lijie, Liu Qian, Li Ye, Lv Qiubo
Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Ann Transl Med. 2020 Dec;8(24):1662. doi: 10.21037/atm-20-7406.
Recently, transvaginal color Doppler ultrasound (TVCDU) has been widely used in the diagnosis of pelvic tumors. This study aimed to assess the reliability of the application of TVCDU in the identification of pelvic tumors in women of childbearing age.
The clinical data of 209 patients with pelvic tumors at childbearing age admitted to our hospital from January 2016 to December 2019 were retrospectively analyzed. The ultrasound signs, color Doppler ultrasound score (CDUS), and resistance index (RI) of benign and malignant pelvic tumors diagnosed by TVCDU were analyzed. The value of transabdominal color Doppler ultrasound (TACDU) and TVCDU in the diagnosis of benign and malignant pelvic tumors was calculated.
There were 150 cases with benign pelvic tumors and 59 cases with malignant tumors. Most benign tumors had an intact capsule and regular shape, were mainly cystic, and were rarely accompanied by ascites; meanwhile, malignant tumors were mostly non-capsular and irregular in shape, mainly solid or cystic, and were often accompanied by ascites. There were significant differences in the above-mentioned ultrasound signs between benign and malignant tumors (P<0.05). The CDUS score of benign pelvic tumors was significantly lower than that of malignant tumors, and the RI value was significantly higher than that of the malignant tumors (P<0.05). The sensitivity, specificity, and accuracy of TACDU in the diagnosis of benign pelvic and malignant tumors were 83.33%, 84.75%, and 83.73%, respectively; and the sensitivity, specificity, and the accuracy of TVCDU in the diagnosis of benign pelvic and malignant tumors were 95.33%, 88.14%, and 93.30%, respectively; thus TVCDU had a superior performance compared to TACDU, especially in sensitivity and accuracy (P<0.05).
The sensitivity and accuracy of TVCDU in the differential diagnosis of benign pelvic and malignant tumors in women at childbearing age were significantly higher than those of TACDU. The combined application of CDUS and RI can further improve the accuracy in the diagnosis of pelvic tumors.
近年来,经阴道彩色多普勒超声(TVCDU)已广泛应用于盆腔肿瘤的诊断。本研究旨在评估TVCDU在识别育龄期女性盆腔肿瘤中的应用可靠性。
回顾性分析2016年1月至2019年12月我院收治的209例育龄期盆腔肿瘤患者的临床资料。分析经TVCDU诊断的良性和恶性盆腔肿瘤的超声征象、彩色多普勒超声评分(CDUS)及阻力指数(RI)。计算经腹彩色多普勒超声(TACDU)和TVCDU在诊断良性和恶性盆腔肿瘤中的价值。
良性盆腔肿瘤150例,恶性肿瘤59例。大多数良性肿瘤包膜完整、形态规则,主要为囊性,很少伴有腹水;同时,恶性肿瘤大多无包膜、形态不规则,主要为实性或囊性,常伴有腹水。良性和恶性肿瘤上述超声征象差异有统计学意义(P<0.05)。良性盆腔肿瘤的CDUS评分显著低于恶性肿瘤,RI值显著高于恶性肿瘤(P<0.05)。TACDU诊断良性盆腔肿瘤和恶性肿瘤的敏感性、特异性及准确性分别为83.33%、84.75%和83.73%;TVCDU诊断良性盆腔肿瘤和恶性肿瘤的敏感性、特异性及准确性分别为95.33%、88.14%和93.30%;因此,TVCDU的性能优于TACDU,尤其是在敏感性和准确性方面(P<0.05)。
TVCDU在育龄期女性盆腔良恶性肿瘤鉴别诊断中的敏感性和准确性显著高于TACDU。CDUS与RI联合应用可进一步提高盆腔肿瘤诊断的准确性。