声脉冲辐射力弹性成像联合彩色多普勒超声诊断卵巢癌的临床价值

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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

卵巢癌是一组具有高度异质性的恶性肿瘤，根据组织学来源可分为上皮性肿瘤、生殖细胞肿瘤和性索间质肿瘤；其发病部位隐匿于盆腔，早期常无特异性症状，缺乏有效的筛查手段，多数患者确诊时已处于中晚期，5年生存率较低[1-2]。（剩余6118字）