三维超声下良恶性卵巢肿瘤的声像图特征及血流参数比较

摘要

Objective To observe and compare the difference of benign and malignant ovarian tumors in sonographic and blood flow parameters by three-dimensional(3D) power Doppler.Methods 184 patients with ovarian tumors which detected by 3D power Doppler were studied retrospectively .Based on the pathological diagnosis ,all patients were divided into the benign group (n=149) and the malignant group (n=35).The main sonographic,intratumoral vascularization index (VI),flow index (FI) and vascularization-flow index ( VFI) of benign and malignant ovarian tumors by three-dimensional power Doppler were evaluated and compared.Results There were 1 case of malignant ovarian tumors missed diagnosis and 4 cases of benign ovarian tumors misdiagnosis .The character of sonographic in malignant group were solid with dispersion in liquid zone ,and the blood vessels were mostly typeⅢ(85.7%).The character of sonographic in benign group were liquid with more separation ,and the blood vessels were mostly typeⅠ(91.9%).There were significant differences between means for benign and malignant masses for following parameters:VI,FI and VFI (P<0.05).The VI,FI and VFI in stageⅠ,Ⅱ ovarian cancers and in stage Ⅲ,Ⅳ ovarian cancers had no difference(P>0.05).Conclusion There are obvious differences between benign and malignant tumors in sonographic and blood flow parameters .3D power Doppler could offer valuable information before surgery ,but could not help to evaluate the stage of ovarian cancers .%目的：比较分析良、恶性卵巢肿瘤三维超声检查下的声像图及血流参数特征。方法184例卵巢肿瘤患者，以病理检查为金标准，分为良性组（149例）和恶性组（35例），观察并比较良性组、恶性组经阴道三维多普勒超声的特征。结果1例卵巢癌漏诊，4例良性卵巢肿瘤误诊为恶性。恶性组多为实性伴散在液性区，血流分型以Ⅲ型为主（30/35，85．7％）；良性组多为液性伴较多分隔，血流分型以Ⅰ型为主（137/149，91．9％），两组血流分型差异明显（P＜0．05）。良性组VI、FI、VFI均显著小于恶性组（P＜0．05）；不同临床分期卵巢癌其血流参数间无显著差异（P＞0．05）。结论卵巢良性肿瘤与卵巢癌在声像图、血流分布、血流分型等方面均有明显不同，三维多普勒超声对恶性卵巢肿瘤术前诊断较准确，但不能区分卵巢癌分期。