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目的:分析恶性危险指数(RMI)中超声影像学指标的可行性,并探讨RMI在绝经后卵巢肿块的术前良恶性的诊断及处理中应用。方法:回顾性分析546例绝经后卵巢肿块患者的临床病理资料。结果:绝经后卵巢肿块双侧病变的恶性率大于单侧病变者;单侧卵巢肿块最大径线>10 cm的恶性率大于最大径线≤10 cm者;多个分隔无助于良恶性的判断。RMI 2诊断绝经后卵巢恶性肿块的灵敏度大于RMI 1、RMI 3及血清CA125。血清CA125、RMI 1、RMI 2诊断绝经后卵巢恶性肿块的特异度均大于超声评分,RMI 1诊断绝经后卵巢恶性肿块的特异度大于RMI 2。绝经后无不适症状、超声检查为完全无回声区、单侧单房囊肿且囊壁光滑,且检测血清CA125者22例,血清CA125均<35 U/ML,最大径线均<10 cm,按RMI 2进行危险度分型,低危型均无恶性病变发生。结论:RMI 2更值得应用于绝经后卵巢肿块术前良恶性的判断,从而指导治疗及手术方式的选择。但仍存在改良的必要性和空间。RMI 2<25为低危型,可应用于绝经后无不适症状、超声检查为完全无回声区、单侧单房囊肿、囊壁光滑者,行保守治疗的筛选中。
Objective: To analyze the feasibility of ultrasonic imaging in malignant risk index (RMI) and to explore the application of RMI in the diagnosis and treatment of benign and malignant premenopausal ovarian masses. Methods: The clinicopathological data of 546 cases of postmenopausal ovarian masses were retrospectively analyzed. Results: The malignant rates of bilateral lesion in postmenopausal ovarian masses were higher than those in unilateral lesion. The malignant rate of unilateral ovarian masses with the largest diameter> 10 cm was larger than that with the largest diameter less than 10 cm. . The sensitivity of RMI 2 in the diagnosis of postmenopausal ovarian malignancies is greater than that of RMI 1, RMI 3, and serum CA125. The specificity of serum CA125, RMI 1 and RMI 2 in diagnosing ovarian malignant tumors in postmenopausal women were all higher than those in ultrasound scores. The specificity of RMI 1 in diagnosing postmenopausal ovarian malignant tumors was higher than that of RMI 2. Postmenopausal no symptoms, ultrasound examination for the complete absence of echo area, unilateral single room cyst and smooth wall, and the detection of serum CA125 were 22 cases, serum CA125 were <35 U / ML, the maximum diameter are <10 cm, according to RMI 2 risk type, low-risk type no malignant lesions. Conclusion: RMI 2 is more suitable for preoperative evaluation of benign and malignant ovarian masses in order to guide the choice of treatment and surgical methods. However, there is still room for improvement. RMI 2 <25 for the low-risk type, can be applied to post-menopausal without discomfort, sonographic examination for the complete absence of echo, unilateral single-celled cysts, stenosed, line conservative treatment screening.