螺旋CT及磁共振对输卵管脓肿的诊断价值分析

摘要

目的 研究并探讨螺旋CT 及磁共振成像(MRI)对输卵管脓肿的诊断价值.方法 选取2014年1月～2017年11月我院收治的60例疑似输卵管脓肿患者作为研究对象,所有患者均接受螺旋CT 检查、MRI 检查,由2名医师阅片,分析患者的CT 图像、MRI 图像,分别作出诊断.以穿刺活检或手术病理诊断结果为参照,计算和比较螺旋CT、MRI 对输卵管脓肿的诊断灵敏度、特异度、准确率,并采用一致性检验方法,分析螺旋CT、MRI 诊断输卵管脓肿与病理诊断结果之间的诊断一致性.结果 60例疑似输卵管脓肿患者中,经穿刺活检或手术病理诊断,共有38例患者确诊为输卵管脓肿,其余22例患者排除为输卵管脓肿.以病理诊断结果为参照,螺旋CT 对输卵管脓肿的诊断灵敏度、特异度、准确率分别为92.11％、90.91％、91.67％,MRI 对输卵管脓肿的诊断灵敏度、特异度、准确率分别为97.37％、95.45％、96.67％,两者比较,差异均无统计学意义(P＞0.05).经一致性检验,螺旋CT、MRI 诊断输卵管脓肿与病理诊断结果之间的诊断一致性均良好,Kappa 值分别为0.716、0.703.结论 在输卵管脓肿诊断中,螺旋CT、MRI 均有较高的诊断准确性,其诊断结果与病理诊断结果均较为接近,可将螺旋CT 与MRI 进行联合诊断,作为输卵管脓肿术前诊断方法.%Objective To explore the diagnostic value of spiral CT and magnetic resonance imaging (MRI) in the diagnosis of fallopian tube abscess.Methods A total of 60 cases of suspected fallopian tube abscess in our hospital from January 2014 to November 2017 were selected as the subject.All the patients were examined by spiral CT and MRI.The CT images and MRI images of the patients were analyzed by two doctors to make a diagnosis respectively.The diagnostic sensitivity,specificity and accuracy of spiral CT and MRI in the diagnosis of fallopian tube abscess were calculated and compared with the results of biopsy or pathological diagnosis.The consistency test was used to analyze the diagnostic consistency between spiral CT and MRI for the diagnosis of tubal abscess and pathological diagnosis.Results Among 60 suspected tubal abscesses,38 cases were diagnosed as tubal abscess by biopsy or surgical pathology.The remaining 22 patients were excluded as fallopian tube abscess.Reference to the results of pathological diagnosis,the diagnostic sensitivity,specificity and accuracy of spiral CT in the diagnosis of fallopian tube abscess were 92.11％,90.91％ and 91.67％,respectively,which were respectively 97.37％,95.45％ and 96.67％ of MRI,and there was no significant difference the two methods (P＞0.05).The consistency test showed that the diagnostic consistency between spiral CT,MRI and pathological diagnosis for the diagnosis of fallopian tubal abscess were all good,the Kappa value was 0.716 and 0.703, respectively.Conclusion In the diagnosis of fallopian tube abscess,spiral CT and MRI all have high diagnostic accuracy, and their diagnostic results are close to those of pathological diagnosis.Combined diagnosis of spiral CT and MRI can be used as a preoperative diagnostic method for fallopian tubal abscess.