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目的对超声诊断绝经后妇女卵巢肿物的临床价值进行分析。方法回顾性分析我院2011-06-2015-06收治的98例经手术证实为绝经后妇女卵巢肿物患者,对绝经后妇女卵巢肿物的临床特征以及超声声像图特点进行探讨,并分析超声对绝经后各种病理类型卵巢肿瘤的诊断符合率。结果 98例绝经后妇女卵巢肿物患者,术后经病理学鉴定良性71例,恶性27例。绝经后妇女卵巢肿物双侧病变的恶性率明显著性高于单侧病变患者(χ2=18.598,P<0.05);绝经后单侧卵巢肿块各最大径线组恶性病变发生率有显著统计学差异(χ2=18.505,P<0.05),单侧卵巢肿块最大径线>10cm的恶性病变发生率明显高于最大径线<5cm及5~10cm患者(χ2=8.533、4.571,P<0.05)。在超声二维声像图指标方面,肿物不规则的恶性病变发生率明显高于肿物规则者(χ2=5.513,P<0.05);壁结构异常的恶性病变发生率明显高于壁结构正常者(χ2=57.733,P<0.05);有腹水者恶性病变发生率明显高于无腹水者(χ2=29.076,P<0.05)。恶性肿物血流分级中0级与Ⅰ级比率显著低于良性肿物(χ2=21.639、31.642,P<0.05),Ⅱ级与Ⅲ级比率显著高于良性肿物(χ2=73.406、80.546,P<0.05)。恶性肿物RI≤0.43与PI≤1.0比率显著性高于良性肿物患者(χ2=35.392、32.327,P<0.05)。RI诊断恶心肿物的敏感度为95.3%,特异度为83.3%,准确度为95.3%。PI诊断恶心肿物的敏感度为91.3%,特异度为85.0%,准确度为91.3%。结论超声检查对绝经后妇女卵巢肿物的良恶性进行诊断具有十分重要的应用价值,可为患者治疗方案的选择提供依据,具有重要的临床意义。
Objective To analyze the clinical value of ultrasonic diagnosis of ovarian masses in postmenopausal women. Methods A retrospective analysis of 98 cases of ovarian masses confirmed by postmenopausal women in our hospital from June 2011 to June 2015 was performed. The clinical characteristics and the ultrasonographic features of postmenopausal women with ovarian masses were analyzed and analyzed Ultrasound on postmenopausal pathological types of ovarian cancer diagnostic coincidence rate. Results 98 cases of postmenopausal women with ovarian tumor patients, pathologically identified 71 cases of benign and malignant in 27 cases. Postmenopausal women ovarian tumor bilateral lesion malignancy was significantly higher than those in unilateral lesions (χ2 = 18.598, P <0.05); unilateral ovarian mass in the largest diameter of the line group of malignant lesions were statistically significant (Χ2 = 18.505, P <0.05). The incidence of malignant lesions with the largest diameter> 10 cm in unilateral ovarian masses was significantly higher than those with largest diameter <5 cm and 5 ~ 10 cm (χ2 = 8.533, 4.571, P <0.05). The incidence of irregular malignant lesions in tumor was significantly higher than that in tumor rule (χ2 = 5.513, P <0.05). The incidence of malignant lesions with abnormal wall structure was significantly higher than that with normal wall structure (Χ2 = 57.733, P <0.05). The incidence of malignant lesions with ascites was significantly higher than that without ascites (χ2 = 29.076, P <0.05). The grade 0 and grade Ⅰ in grade of malignant tumor were significantly lower than those in benign mass (χ2 = 21.639, 31.642, P <0.05), and the grade Ⅱ and Ⅲ were significantly higher than those in benign mass (χ2 = 73.406 and 80.546, P <0.05). The ratio of RI≤0.43 to PI≤1.0 in malignant tumor was significantly higher than that in benign tumor (χ2 = 35.392, 32.327, P <0.05). The sensitivity of RI in diagnosing nausea was 95.3%, the specificity was 83.3% and the accuracy was 95.3%. The sensitivity, specificity and specificity of PI in diagnosing nausea and swelling of the tumor were 91.3%, 85.0% and 91.3% respectively. Conclusion Ultrasonography has very important value in the diagnosis of benign and malignant ovarian tumors in postmenopausal women, which can provide the basis for the selection of treatment options and has important clinical significance.