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目的 :运用螺旋CT评价原发卵巢恶性肿瘤手术难度 ,帮助术前确定手术范围 ,以提高治疗效果。方法 :通过回顾性分析 98例有手术病理结果的原发恶性肿瘤患者的CT资料 ,对原发病灶周围脂肪间隙、周围脏器的改变、周围血管受累、肿瘤血供多少及转移灶所形成腹膜肿块、腹膜粘连、大网膜饼、腹水及淋巴结侵犯的CT征象与手术病理结果进行对比 ,同时对影响手术难度的征象与手术过程中难度大小进行对比分析。结果 :螺旋CT对原发灶及转移灶的影响手术难度的CT征象的显示有较高的敏感性、特异性。特别是对腹水、肠道受侵、肝脾受侵、淋巴结肿大螺旋CT检查的特异性达 10 0 %。结论 :螺旋CT能准确地反映原发卵巢恶性肿瘤影响手术难度的重要征象 ,又具有较高的敏感性和特异性 ,可作为卵巢恶性肿瘤术前分期的主要参考依据 ,能作为可切除性的判断指标 ,能较准确地在术前估计手术范围。
Objective: To evaluate the surgical difficulty of primary malignant ovarian tumors by using helical CT, to help determine the scope of surgery before surgery to improve the therapeutic effect. Methods: CT data of 98 patients with primary malignant tumor with pathological findings were retrospectively analyzed. The changes of fat space around the primary lesion, changes in the surrounding organs, peripheral blood vessels involved, blood supply to the tumor and the peritoneum formed by the metastases CT signs of tumor, peritoneal adhesions, omentum cake, ascites and lymph nodes were compared with those of surgical pathology. At the same time, comparative analysis was made between the signs of difficulty affecting operation and the difficulty of operation. Results: Spiral CT on the primary lesion and metastasis of CT difficult signs of surgery showed a higher sensitivity and specificity. Especially for ascites, intestinal invasion, liver and spleen invasion, lymph node enlargement of the specificity of spiral CT examination up to 10%. Conclusion: Spiral CT can accurately reflect the primary malignant ovarian tumors affect the operation of the important signs of difficulty, but also has a high sensitivity and specificity, can be used as the main reference for the preoperative staging of ovarian cancer, as a resectability Judgment indicators, can more accurately estimate the scope of surgery before surgery.