| 摘要: |
| ［摘要］目的 探讨超声造影在盆腔包块良恶性的鉴别诊断的价值．方法 选取2014年10月至2016年1月在昆明医科大学第一附属医院门诊和住院部就诊，行经阴道或经腹常规超声发现盆腔包块的患者62例，共64个包块，常规超声提示为盆腔囊性、囊实混合性、实性包块，对64个盆腔包块行超声造影检查．观察盆腔包块造影剂灌注过程，分析灌注模式和灌注强度及时间强度曲线，其诊断结果与病理结果、长期随访结果对照，分为良性组和恶性组，分析和比较2组时间强度曲线形态及各造影参数．结果 64个盆腔包块，其中62个经穿刺或手术病理证实、2个经长期随访证实：良性组43个，恶性组21个．良性组包块造影剂多由周边向中心灌注，均匀性等增强，血管走形规则；恶性组多由中心向周边灌注，快速不均匀性高增强，血管走形迂曲．时间强度曲线形态良性组多呈“缓升缓降型”，恶性组多呈“速升速降型”．恶性组上升时间（RS）（7.70±2.56）s，较良性组（11.40±6.77）s早（P＜0.05），峰值强度（PI）（16.30±7.41）dB，大于良性组（12.12±6.70）dB（P＜0.05）、曲线下面积（AUC）（981.65±548.04）dB s，大于良性组（715.22±651.04）dB s（P＜0.05），但峰值强度（TP）、平均渡越时间（MTT）2组之间比较差异无统计学意义（P＞0.05），超声造影诊断盆腔包块灵敏度95.2%，特异度93.0%，阳性预测值86.9%，阴性预测值97.5%．结论 超声造影能很好的显示包块的血流灌注情况及血管分布特征，分析其包块造影剂增强模式、时间强度曲线形态及各个参数指标，能有效提高盆腔包块良恶性诊断及鉴别诊断的能力． |
| 关键词: ［关键词］盆腔包块 超声造影 良恶性 |
| DOI： |
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| 基金项目:［基金项目］昆明医科大学研究生创新基金资助项目（2015ST4） |
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| Diagnostic Value of Contrast-enhanced Ultrasonography in Differentiating Benign and Malignant Tumor of Pelvic Cavity |
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WU Jue
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（The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China）
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| Abstract: |
| ［Abstract］Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity．Methods From October 2014 to January 2016，abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University. We found 62 cases with pelvic cavity tumors with 64 lumps， which were detected at cystic mass，cystic-solid mass，and solid mass in conventional ultrasonography. We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography，observing the infusion process and analyzing perfusion pattern，the intensity of perfusion and time intensity curve. By contrasting the diagnosis and the pathologic and long-term follow-up results，we classified the tumors into two groups， benign and malignant. Then we analyzed the time intensity curve and imaging parameters of the two groups．Results Among the total 64 lumps， 43 was found in the group of benign tumor and 21 in the group of malignant tumor. Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results. Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped. Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally， and vessels were distorted. In the time intensity curve，group of benign tumors presented a gently slow raise and fall type， and group of malignant tumors showed a quickly raise and fall type．Rise time （RT） of malignant group（7.70±2.56s）was shorter than benign group（11.40±6.77s）（P＜0.05）．Peak intensity（PI）of malignant group（16.30±7.41dB）was higher than benign group （12.12±6.70dB） （P＜0.05）. Area Under the Curve（AUC） of malignant group（981.65±548.04 dB s）was bigger than benign group （715.22±651.04dB s）（P＜0.05）. No difference was found between two groups in Time to Peak（TP）and Mean Transit Time （MTT）（P＞0.05）. The sensitivity，specificity，positive and negative predictive value of contrast-enhanced ultrasonography were 95.2%， 93.0%，86.9%，and 97.5% respectively．Conclusion Contrast-enhanced ultrasonography can show an eligible blood perfusion and vascularity of lumps. Analyzing perfusion pattern， time intensity curve，and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity. |
| Key words: ［Key words］Contrast-enhanced ultrasonography Tumor of pelvic cavity Benign and malignant tumor |