Guerriero S, Ajossa S, Mais V, Risalvato A, Lai M P, Melis G B
Department of Obstetrics and Gynaecology of the University of Cagliari, Ospedale San Giovanni di Dio, Italy.
Hum Reprod. 1998 Jun;13(6):1691-5. doi: 10.1093/humrep/13.6.1691.
We studied the role of colour Doppler energy (CDE) (or power Doppler) imaging in the differentiation between endometriomas and other adnexal masses in premenopausal non-pregnant women. A total of 170 consecutive patients with persistent adnexal masses was submitted to B-mode transvaginal ultrasonography associated with CDE imaging evaluation. Plasma concentrations of CA125 were measured before surgery. Using CDE imaging evaluation of vessel distribution, the occurrence of one of the following findings was considered to indicate the likely presence of endometrioma: (i) a round-shaped homogeneous hypoechoic 'tissue' of low-level echoes without papillary proliferations associated with 'poor' vascularization; (ii) a round-shaped homogeneous hypoechoic 'tissue' of low-level echoes with an echogenic portion in which no flow was detected. The overall agreement between the test result and the actual outcome was calculated using the k index. The CDE imaging evaluation was more accurate in the diagnosis of endometriomas compared with B-mode ultrasonography alone (k = 0.88 and 0.80 respectively). According to the logistic regression equation obtained, the probability of the presence of endometrioma varied between a minimum of 1.4% for patients with no risk factors to a maximum of 95.6% for patients with two risk factors (CDE result and value of CA125 >25 IU/ml).
我们研究了彩色多普勒能量（CDE）（或功率多普勒）成像在绝经前未怀孕女性子宫内膜异位囊肿与其他附件包块鉴别诊断中的作用。共有170例连续的附件包块持续存在的患者接受了经阴道B超检查及CDE成像评估。术前检测了CA125的血浆浓度。通过CDE成像评估血管分布，出现以下任何一项表现即被认为可能存在子宫内膜异位囊肿：（i）圆形均匀低回声“组织”，低水平回声，无乳头状增生，伴有“稀疏”血管分布；（ii）圆形均匀低回声“组织”，低水平回声，有一个无血流信号的高回声部分。使用k指数计算检测结果与实际结果之间的总体一致性。与单纯B超检查相比，CDE成像评估对子宫内膜异位囊肿的诊断更准确（k值分别为0.88和0.80）。根据得到的逻辑回归方程，子宫内膜异位囊肿存在的概率在无危险因素的患者中最低为1.4%，在有两个危险因素（CDE结果及CA125值>25 IU/ml）的患者中最高为95.6%。
