聲脈沖輻射力彈性成像聯(lián)合彩色多普勒超聲診斷卵巢癌的臨床價(jià)值

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Clinical value of acoustic radiation force impulse combined with color Doppler ultrasound in the diagnosis of ovarian cancer

WANG Fang，ZHANG Wenjun，WANG Hua，XIA Jingjing Departmentof Ultrasound，Taihe HospitalAffiliated toHubei UniversityofMedicine，，

ABSTRACTObjectiveTo explore the clinical application valueof aoustic radiation force impulse（ARFI）combined withcolorDopplerultrasoundin thediagnosisofovariancancer.MethodsAtotalof74 patientswithovarian tumors confirmed by surgical pathology from our hospital were enrolled and divided into ovarian cancer group （ n =49）and benign group （ n=25 ）.Two-dimensional ultrasound was used to measure the maximum diameter of the lesion，color Doppler ultrasound was usedto measure theresistance index（RI），pulsatity index（PI），peak systolicvelocity（PSV），andend-diastolic velocity （EDV），ARFI was used to measure the maximum，minimum and average shear wave velocity（SWV）of the lesion.The diferences intheaboveparametersbetweenthetwogroups werecompared.Logisticregresionanalysiswasperformedtoscreen theindependentinfluencingfactorsforthediferentialdiagnosisofovarianbenign tumorandovariancancer.Receiveroperating characteristic（ROC）curvewasdrawntoanalyzethediagnosticeficacyofeachparameterindividuallyandincombinationfor ovariancancer.ResultsThe maximum diameter，PSV，EDVand average SWVinovarian cancer group were significantly higher than those in benign group，whileRIandPI were significantlylower than those in benign group（all P <0.05）.Logistic regressionanalysisshowedthattheaverageSWVRIandPIwereindependentriskfactorsforthediffrentialdiagnosisofovarian benign tumor and ovarian cancer（OR=3.670，1.509，1.132，all P <0.05）.ROC curve analysis showed that the area under the curve （AUC）of average SWV，RIandPI in diagnosing ovarian cancer were0.806，0.620andO.682，respectively.The AUCof combined application of these parameters was 0.913（ 95% confidence interval： 0.824＼～0.966），which was significantly higher thanthat of eachparameter（all P<0.001 ）.Thesensitivityand specificityof combined applicationwere 75.51% ， 92.00% ， respectively.ConclusionARFIcombined withcolor Dopplerultrasoundcanimprove thediagnostic eficacyforovariancancer， which has good clinical application value.

KEYWORDS Ultrasonography，Doppler，color;Aoustic radiation force impulse;Ovarian tumor，benign and malignant

卵巢癌是一組具有高度異質(zhì)性的惡性腫瘤，根據(jù)組織學(xué)來源可分為上皮性腫瘤、生殖細(xì)胞腫瘤和性索間質(zhì)腫瘤；其發(fā)病部位隱匿于盆腔，早期常無特異性癥狀，缺乏有效的篩查手段，多數(shù)患者確診時(shí)已處于中晚期，5年生存率較低[1-2]。（剩余6118字）