摘要
目的以超声医师的主观诊断结果为对照,以病理结果为金标准,探讨简单规则鉴别附件区包块良恶性的临床价值。方法收集经病理证实的200例病人200个附件区包块的超声检查图像,分别由2位不同年资超声医师回顾性分析其声像图特征,根据经验得出主观诊断;测试者根据简单规则得出诊断结论,构建受试者工作特征曲线(ROC),比较不同年资超声医师诊断、简单规则诊断附件区包块的灵敏度及特异度。结果病理结果显示,200个包块中良性包块127个(64.5%),恶性包块73个(35.5%),其中15个(7.5%)为交界性。根据简单规则诊断的ROC曲线下面积(AUC)为0.887,灵敏度为83.3%,特异度为84.3%;高年资医师诊断的AUC为0.920,灵敏度为94.4%,特异度为81.1%;低年资医师诊断的AUC为0.828,灵敏度为76.4%,特异度为72.7%。低年资医师诊断的效能低于简单规则,高年资医师的诊断效能明显高于低年资医师及简单规则,差异有显著性(Z=1.98~2.30,P<0.05)。结论应用简单规则能够快速诊断附件区包块,具有较好的临床应用前景,但临床经验的总结和积累仍具有非常重要的意义。
Objective Giving subjective diagnosis result of ultrasound doctors as control and the result of pathology as gold standard,to assess the clinical value of simple rules in distinguishing benign and malignant adnexal masses. Methods A total of ultrasound images of 200 adnexal masses of 200 patients were collected,the image characteristics were retrospectively reviewed by two sonographers of different seniority,a subjective diagnosis was made based on clinical experience.The observer was asked to give a diagnostic conclusion based on the＂simple rules＂.Receiver-operating characteristic curves（ROC）were then created.A comparison of sensitivity and specificity in the diagnosis of adnexal masses were made in ultrasound doctors of different length of service. Results Pathologic results indicated that：in the 200 adnexal masses,127（64.5%）were benign,73（35.5%）were malignant,of which,15（7.5%）were borderline.According to simple rule diagnosis,the area under the ROC curve（AUC）was 0.877,sensitivity was 83.3% and specificity was 84.3%.In senior doctors,the AUC of diagnosis was 0.920,the sensitivity was 94.4% and specificity 81.1%;in junior doctors,the AUC of diagnosis under ROC was 0.828,the sensitivity was 76.4% and specificity was 72.7%.The diagnosis efficiency of junior doctors was lower than that of simple rules,and that of senior doctors was higher than that of junior ones and simple rules（Z=1.98-2.30,P〈0.05）. Conclusion The simple rules can quickly diagnose adnexal masses,which has a good prospect for clinical application,but the summary and accumulation of clinical experience is still very important.
作者
杜晓颖
宁春平
房世保
仲艳密
杨宗利
王宏桥
DU Xiaoying NING Chunping FANG Shibao ZHONG Yanmi YANG Zongli WANG Hongqiao(Department of Ultra- sonography, The Affiliated Hospital of Qingdao University, Qingdao 266003, Chin)
出处
《青岛大学医学院学报》
CAS
2017年第1期31-34,共4页
Acta Academiae Medicinae Qingdao Universitatis
关键词
卵巢肿瘤
超声检查
多普勒
彩色
简单规则
主观评价
ovarian diseases
ullrasonography
Doppler
Color
simple rules
subjective diagnosis
