多层螺旋CT增强扫描对交界性与侵袭性卵巢肿瘤的诊断价值

摘要

Purpose To investigate the diagnostic value of multi-slice spiral CT (MSCT) enhanced scanning in borderline and invasive ovarian tumor,and to provide valuable image evidence for clinical treatment.Materials and Methods One hundred and one patients with pathological-confirmed borderline and invasive ovarian tumor in the First Affiliated Hospital of Jinzhou Medical University from October 2012 to October 2016 were selected,and the preoperative abdominal MSCT enhanced imaging,clinical and pathological data were retrospectively analyzed.The MSCT imaging was observed,and the prediction model of MSCT differentiating borderline and invasive ovarian tumor was established.Results The differences of onset age,menopausal status,tumor solid components,maximum diameter,septa and margin were all statistically significant between borderline and invasive ovarian tumor groups (P＜0.05).The prediction model of MSCT differentiating borderline and invasive ovarian tumor was established using multivariate Logistic regression,on the basis of following variables (OR＞l,P＜0.05):tumor size,solid components and septa.The sensitivity and specificity of the prediction model were respectively 81.3％ (95％ CI:0.622-1.000) and 85.7％ (95％ CI:0.741-0.973) in predicting borderline ovarian tumor for patients before menopause,and respectively 92.1％ (95％ CI:0.835-1.000) and 91.7％ (95％ CI:0.761-1.000) for those after menopause.Conclusion MSCT enhanced scanning is helpful to differential diagnose of borderline and invasive ovarian tumor,and it has important significance for clinical treatment and prognosis evaluation.%目的 探讨多层螺旋CT (MSCT)增强扫描诊断交界性与侵袭性卵巢肿瘤的价值,为交界性与侵袭性卵巢肿瘤的临床治疗提供影像学依据.资料与方法 回顾性分析2012年10月-2016年10月锦州医科大学附属第一医院经病理证实的101例交界性与侵袭性卵巢肿瘤患者术前全腹MSCT增强扫描影像学、临床及病理资料,观察MSCT表现并建立MSCT诊断交界性与侵袭性卵巢肿瘤的预测模型.结果 交界性卵巢肿瘤组与侵袭性卵巢肿瘤组患者的发病年龄、绝经状态及两组肿瘤实性成分、最大径、分隔与边界比较,差异均有统计学意义(P＜0.05);多因素Logistic回归分析得到包括肿瘤大小、实性成分及分隔在内的变量建立MSCT诊断交界性与侵袭性卵巢肿瘤的预测模型(OR＞1,P＜0.05).该模型对于绝经前患者预测交界性肿瘤的敏感度和特异度分别为81.3％ (95％ CI:0.622～1.000)、85.7％ (95％ CI:0.741～0.973);对于绝经后患者的敏感度和特异度分别为92.1％ (95％ CI:0.835～1.000)、91.7％ (95％CI:0.761～1.000).结论 MSCT增强扫描有助于交界性与侵袭性卵巢肿瘤的鉴别诊断,对于两者的临床治疗及预后评估具有重要意义.