摘要
目的观察超声造影(CEUS)诊断附件恶性肿瘤的价值。方法回顾性纳入112例附件单发肿块患者,包括73例良性肿瘤(良性组)和39例恶性肿瘤(恶性组)。对比组间临床资料、实验室指标,以及常规超声(US)卵巢-附件报告和数据系统(O-RADS)分类、CEUS所见及诊断结果(记为CEUS分类)。针对组间差异有统计学意义的临床、实验室指标及US O-RADS分类、CEUS分类行多因素logistic回归分析,筛选附件恶性肿瘤的独立预测因素,并以向前逐步回归方法构建联合模型;分析各单一预测因素及联合模型诊断附件恶性肿瘤的效能。结果组间糖类抗原125(CA125)、US O-RADS分类,以及CEUS增强时间、增强水平和CEUS分类差异均有统计学意义(P均<0.05)。CA125、US O-RADS分类及CEUS分类均为附件恶性肿瘤的独立预测因素(P均<0.05),分别基于CA125+CEUS分类、US O-RADS分类+CEUS分类、CA125+US O-RADS分类+CEUS分类构建联合模型Ⅰ、Ⅱ、Ⅲ。单一CA125、US O-RADS分类、CEUS分类及联合模型Ⅰ、Ⅱ、Ⅲ诊断附件恶性肿瘤的曲线下面积(AUC)分别为0.708、0.809、0.908、0.918、0.945及0.954;其中,联合模型Ⅲ的AUC高于联合模型Ⅰ(Z=-2.142,P=0.032),联合模型Ⅱ与Ⅰ、Ⅲ的AUC差异均无统计学意义(P均>0.05)。结论CEUS能有效诊断附件恶性肿瘤;联合CA125及US ORADS分类可显著提高诊断效能。
Objective To observe the value of contrast-enhanced ultrasound(CEUS)for diagnosing malignant adnexal tumors.Methods Totally 112 patients with single adnexal masse were retrospectively enrolled and divided into benign adnexal tumor group(benign group,n=73)and malignant adnexal tumor group(malignant group,n=39).Clinical data,laboratory indicators,ovarian-adnexal ultrasound reporting and data system(O-RADS)classification based on conventional ultrasound(US),CEUS manifestations and CEUS classification of benign and malignant tumors were compared between groups.Multivariable logistic regression analysis of clinical and laboratory indicators being statistically different between groups,as well as US O-RADS classification and CEUS classification was performed to screen the independent predictors of malignant adnexal tumors,and combined models were constructed using forward stepwise regression method.The efficacy of each independent predictor and combined model for diagnosing malignant adnexal tumors was analyzed.Results Statistical differences of carbohydrate antigen 125(CA125),US O-RADS classification,enhancement time and level of CEUS,as well as CEUS classification were found between groups(all P<0.05).CA125,US O-RADS classification and CEUS classification were all independent predictors of malignant adnexal tumors(all P<0.05).Combined modelⅠ,ⅡandⅢwere constructed based on CA125+CEUS classification,US O-RADS classification+CEUS classification and CA125+US O-RADS classification+CEUS classification,respectively.The area under the curve(AUC)of single CA125 level,US O-RADS classification,CEUS classification and combined modelⅠ,ⅡandⅢfor diagnosing malignant adnexal tumor was 0.708,0.809,0.908,0.918,0.945 and 0.954,respectively.AUC of combined modelⅢwas higher than that of combined modelⅠ(Z=-2.142,P=0.032),while no significant difference of AUC was found between combined modelⅡandⅠnorⅡandⅢ(both P>0.05).Conclusion CEUS could be used to effectively diagnose malignant adnexal tumor.Combining with CA125 level and US O-RADS classification could significantly improve its diagnostic efficacy.
作者
张君
洪礼伟
洪思婕
钟晓红
李胜利
胡麦果
何晓琴
钟燕秋
钟丽萍
ZHANG Jun;HONG Liwei;HONG Sijie;ZHONG Xiaohong;LI Shengli;HU Maiguo;HE Xiaoqin;ZHONG Yanqiu;ZHONG Liping(Department of Ultrasound,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen 361003,China;Department of Ultrasound,Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University,Shenzhen 518000,China)
出处
《中国介入影像与治疗学》
北大核心
2025年第8期534-538,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
子宫附件
超声造影
糖类抗原125
人附睾蛋白4
adnexa uteri
contrast-enhanced ultrasound
carbohydrate antigen 125
human epididymis protein 4
