彩色多普勒(TVCDU)、三维彩色能量成像(3D-CPA)联合脉冲多普勒(PW)鉴别卵巢占位病变性质及对恶性病变术前分期的评估价值

doi:10.7517/issn.1674-0475.201105

摘要/Abstract

摘要： 本研究探讨了彩色多普勒（TVCDU）、三维彩色能量成像（3D-CPA）联合脉冲多普勒（PW）鉴别卵巢占位病变性质及对恶性病变术前分期的评估价值。选取卵巢占位病变患者110例，其中恶性肿瘤49例、良性肿瘤61例，均给予彩色多普勒超声检查。恶性肿瘤患者的肿瘤血管收缩期峰值流速（PSV）和血管指数（VI）明显高于良性肿瘤患者，而阻力指数（RI）明显低于良性肿瘤（P<0.05）。恶性肿瘤血管分级Ⅲ级比例明显高于良性肿瘤，而Ⅰ级比例明显少于良性肿瘤（P<0.05）。恶性肿瘤患者中，FIGO分期Ⅲ期患者的VI和血管分级Ⅲ级比例明显高于Ⅰ~Ⅱ患者（P<0.05）。RI、VI、血管分级及联合诊断恶性肿瘤的ROC曲线下面积分别为0.794、0.774、0.937和0.966；VI、血管分级及联合诊断恶性肿瘤FIGO分期Ⅲ期的ROC曲线下面积分别为0.810、0.691和0.955。由此可知，TVCDU、3D-CPA联合PW在鉴别卵巢占位病变性质及恶性病变术前分期评估中有较好的应用价值。

关键词: 彩色多普勒, 三维彩色能量成像, 脉冲多普勒, 卵巢占位病变, 良性, 恶性, 术前分期

Abstract: The aim of this paper was to investigate the value of transvaginal color Doppler ultrasonography (TVCDU), three-dimensional color power angiography (3D-CPA) combined with pulse wave Doppler (PW) in the differential diagnosis of ovarian space-occupying lesions and the evaluation of preoperative staging of malignant lesions. There were 110 patients with ovarian space-occupying lesions who were selected and examined by color Doppler ultrasound, among whom 49 cases were malignant, 61 cases were benign. The peak systolic velocity (PSV) and vascular index (VI) of malignant tumors were significantly higher than those of benign tumors (P<0.05), while resistance index (RI) was significantly lower than that of benign tumors (P<0.05). The proportion of vascular grade Ⅲ of malignant tumors was significantly higher than that of benign tumors (P<0.05), while the proportion of grade Ⅰ was significantly less than that of benign tumors (P<0.05). The proportion of VI and vascular grade Ⅲ in 455 stage Ⅲ patients was significantly higher than that of patients Ⅰ-Ⅱ (P<0.05). The area under ROC curve of RI, VI, vascular classification and combined diagnosis on malignant tumor were 0.794, 0.774, 0.937 and 0.966, respectively. The area under the ROC curve of VI, vascular grading and combined diagnosis of malignant tumor FIGO stage Ⅲ were 0.810, 0.691 and 0.955. In conclusion, TVCDU and 3D-CPA combined with PW have good application value in differentiating the nature of ovarian mass lesions and preoperative staging assessment of malignant lesions.

Key words: color Doppler, three-dimensional color power angiography, pulse Doppler, ovarian space-occupying lesions, benign, malignant, preoperative staging

胥春霞, 赖欣. 彩色多普勒(TVCDU)、三维彩色能量成像(3D-CPA)联合脉冲多普勒(PW)鉴别卵巢占位病变性质及对恶性病变术前分期的评估价值[J]. 影像科学与光化学, 2021, 39(3): 455-459.

XU Chunxia, LAI Xin. Value of TVCDU, 3D-CPA Combined with Pulse Wave Doppler (PW) in the Differential Diagnosis of Ovarian Space-occupying Lesions and the Evaluation of Preoperative Staging of Malignant Lesions[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(3): 455-459.

参考文献

[1] 李孟达. 卵巢恶性肿瘤的诊断和治疗[M]. 广州:广东科技出版社, 1985. 23-25.
[2] 中华医学会. 全国复发性卵巢恶性肿瘤诊断与治疗学术研讨会论文汇编[C]. 北京:中华医学会, 2002. 13-15.
[3] 罗荣城, 韩焕兴. 肿瘤综合诊疗新进展(第3版)[M]. 北京:人民军医出版社, 2008. 18-19.
[4] 唐丽娜, 任永富, 阎若元, 等. 经阴道超声诊断卵巢肿瘤的价值[J]. 临床超声医学杂志, 2007,9(1):34-37.
[5] 陈晓丽. 彩色多普勒超声在卵巢肿瘤诊断中的应用效果[J]. 中国民康医学, 2020,32(8):114-115.
[6] 林仲秋. FIGO/IGCS妇科恶性肿瘤分期及临床实践指南(六):卵巢癌[J]. 国际妇产科学杂志, 2008,35(6):459-459.
[7] Abramowicz J S, George C, Dirk T. Ovarian mass-differentiating benign from malignant. Why the international ovarian tumour analysis rules should be implemented in Australasia[J]. Australasian Journal of Ultrasound in Medicine, 2018,21(3):121-124.
[8] 李玲, 周一波, 吴美艳, 等. 卵巢肿瘤超声造影血流特征与肿瘤恶性程度的相关性研究[J]. 中华内分泌外科杂志, 2018,12(2):150-153.
[9] Shah K, Mishra V, Goel S, et al. Role of three-dimensional power doppler angiography in assessment of perifollicular ovarian vascularity in patients undergoing in vitro fertilization:a single center experience[J]. Donald School Journal of Ultrasound in Obstetrics and Gynecology, 2018,12(3):162-167.
[10] Militaru S, Bonnefous O, Hami K, et al. Validation of semiautomated quantification of mitral valve regurgitation by three-dimensional color Doppler transesophageal echocardiography[J]. Journal of the American Society of Echocardiography, 2020,33(3):342-354.
[11] Abd E L A, Elshorbagy S H, Elbadry A M, et al. Role of color Doppler ultrasonography and multidetector computed tomography angiography in diagnosis of uterine arteriovenous malformations[J]. Egyptian Journal of Radiology & Nuclear Medicine, 2018,49(2):590-596.
[12] Rafailidis V, Chryssogonidis I, Xerras C, et al. A comparative study of color Doppler imaging and contrast-enhanced ultrasound for the detection of ulceration in patients with carotid atherosclerotic disease[J]. European Radiology, 2019,29(4):2137-2145.
[13] Chaoui R, Merz E, Heling K S. Three-dimensional visualization of a fetal double aortic arch with HDlive color Doppler[J]. Ultraschall in der Medizin, 2019,40(3):285-286.
[14] 郭启靖, 骆玉露, 吴密璐, 等. 阴道三维能量多普勒与核磁共振对子宫内膜良恶性疾病诊断的探讨[J]. 安徽医药, 2018,22(9):1770-1772.
[15] Cigale B, Zazula D. Directional 3D wavelet transform based on Gaussian mixtures for the analysis of 3D ultrasound ovarian volumes[J]. IEEE Transactions on Pattern Analysis and Machine Intelligence, 2018,41(1):64-77.
[16] Wang X N, Zhao Q, Li D, et al. Quantitative evaluation of primary retinitis pigmentosa patients using colour Doppler flow imaging and optical coherence tomography angiography[J]. Acta Ophthalmologica, 2019,97(7):993-997.
[17] Ilary R, Dan C T, Ignace V, et al. Characterisation of tumour microvessel density during progression of high-grade serous ovarian cancer:clinico-pathological impact (an OCTIPS Consortium study)[J]. British Journal of Cancer, 2018,119(3):330-338.
[18] Rajan P T, Suresh T N, Rajashekar T S. Expression of vascular endothelial growth factor and microvessel density in psoriatic skin lesions[J]. Indian Dermatology Online Journal, 2018,9(6):418-421.