摘要
目的以病理诊断为依据,评估多层螺旋CT(multi⁃slice spiral CT,MSCT)增强扫描诊断卵巢交界性浆液性肿瘤(serous borderline ovarian tumor,S⁃BOT)和交界性黏液性肿瘤(mucinous borderline ovari⁃an tumor,M⁃BOT)的价值。方法回顾性分析我院经手术病理证实的39例S⁃BOT和46例M⁃BOT患者的术前影像、临床及病理资料,分析并比较肿瘤的MSCT表现。结果以病理结果为金标准,MSCT增强扫描诊断卵巢S⁃BOT和M⁃BOT的灵敏度为87.2%、特异度为89.1%、准确度为88.2%,Kappa值为0.763。S⁃BOT与M⁃BOT在分房、囊液均质、囊壁/间隔增厚、肿块最大经、肿块实性成分平扫CT值及强化率等方面差异有统计学意义(P<0.05)。S⁃BOT单/双房多见,M⁃BOT多房多见;S⁃BOT较M⁃BOT囊液密度更均质;M⁃BOT较S⁃BOT的囊壁/间隔增厚多见;S⁃BOT最大径小于M⁃BOT;S⁃BOT实性成分平扫CT值低于M⁃BOT;二者增强扫描均表现为渐进性延迟强化,S⁃BOT各期强化率均高于M⁃BOT。出血及钙化在两组间差异无统计学意义(P>0.05)。多因素logistic回归显示分房、囊壁/间隔增厚及肿块实性成分平扫CT值在鉴别S⁃BOT及M⁃BOT中具有独立预测价值。结论MSCT增强扫描对卵巢S⁃BOT和M⁃BOT的诊断与病理诊断的一致性较好,其或可作为卵巢S⁃BOT与M⁃BOT的鉴别诊断的有效手段。
Objective To evaluate the diagnostic value of multi⁃slice spiral CT(MSCT)enhanced scan⁃ning in diagnosing the serous borderline ovarian tumor(S⁃BOT)and mucinous borderline ovarian tumor(M⁃BOT)based on the pathological diagnosis.Methods The preoperative imaging,clinical and pathological data of 39 cases of S⁃BOT and 46 cases of M⁃BOT confirmed by surgical pathology were retrospectively analyzed in our hospital,and the MSCT manifestations of the tumors were analyzed and compared.Results Taking the pathological results as the gold standard,MSCT enhanced scanning had a sensitivity of 87.2%,a specificity of 89.1%,an accuracy of 88.2%,and a Kappa value of 0.763 in the diagnosis of S⁃BOT and M⁃BOT.S⁃BOT and M⁃BOT had statistically significant differences in chamber distribution,homogenization of cystic fluid,thickening of the cyst wall/septum,maximum diameter of the mass,the CT value and the enhancement degree of the solid component(P<0.05).S⁃BOT mostly appeared as a single or double chamber cyst,M⁃BOT showed mostly multi⁃chamber performance;S⁃BOT cystic fluid density was more homogenous than that of M⁃BOT;M⁃BOT was more common than S⁃BOT in the thick⁃ening of the wall/septum;The maximum diameter of S⁃BOT was smaller than that of M⁃BOT;the solid component CT scan value of S⁃BOT was lower than that of M⁃BOT;both S⁃BOT and M⁃BOT showed delayed enhancement.The enhancement rate of S⁃BOT in each phase was higher than that of M⁃BOT.Hemorrhage and calcification had no statistical difference between the S⁃BOT and the M⁃BOT(P>0.05).Multivariate logistic regression showed that the characteristics of the chamber distribution,thickening of the wall/septum and the CT value of the solid compo⁃nent had independent predictive value in identifying S⁃BOT and M⁃BOT.Conclusion MSCT enhanced scanning had a good consistency between the diagnosis of S⁃BOT and M⁃BOT and pathological diagnosis,and it may be used as an effective approach for the differential diagnosis of S⁃BOT a
作者
李亚敏
金钰铌
芮芳
雷静
陆琳
LI Yamin;JIN Yuni;RUI Fang;LEI Jing;LU Lin(Department of Radiology,the First Affiliated Hospital of Kunming University,Kunming 650032,China)
出处
《实用医学杂志》
CAS
北大核心
2021年第11期1476-1480,共5页
The Journal of Practical Medicine
