卵巢甲状腺肿的术前影像学诊断及鉴别
Preoperative imaging diagnosis and differential diagnosis of struma ovarii
王进进 1肖美玲 2周建军 3计一丁 1蔡宋琪 3曾蒙苏3
作者信息
- 1. 215200 江苏,苏州大学附属苏州九院影像科
- 2. 201508 上海,复旦大学附属金山医院放射科
- 3. 200032 上海,复旦大学附属中山医院放射科上海市医学影像研究所
- 折叠
摘要
目的:对照分析卵巢甲状腺肿(SO)与Ⅰ期上皮性卵巢癌(EOC)的临床及影像学资料,总结SO 的临床特点及影像学特征.方法:回顾性分析经手术及病理确诊的 42 例 SO 与 40 例Ⅰ期 EOC患者的临床及影像学资料,临床资料包括症状、年龄、肿瘤指标(CA125、HE4 和 CA19-9),影像学资料包括病变部位、数目、大小、形态、质地、囊壁及分隔厚度、CT 密度、MRI 信号特征、强化方式及程度等.比较两组患者的临床指标及影像学特征是否有统计学差异;通过多因素回归分析明确独立预测因素,并计算诊断效能.结果:Ⅰ期EOC组 CA125(P＜0.001)及 HE4(P＜0.001)异常升高、绝经后阴道流血症状(P＝0.005)的发生率均高于SO 组.两组肿瘤的质地、蜂房、壁结节、囊液密度、实性信号、肿块强化方式及程度差异均有统计学意义(P＜0.05);其中 CA125 及肿瘤实性部分强化程度是鉴别 SO 与 I期EOC的独立预测因素(P＝0.022,OR＝ 0.128;P＝0.002,OR＝11.148),两者联合诊断 SO 的 ROC曲线下面积为 0.857,敏感度为 66.7%,特异度为 90.0%.结论:SO与Ⅰ期EOC在临床症状、肿瘤标志物及影像学特征上均有差异,其中CA125 及肿瘤实性成分强化程度是两者鉴别诊断的独立预测因素.
Abstract
Objective:This study aims to compare the clinical and imaging characteristics of stru-ma ovarii(SO)and stage Ⅰ epithelial ovarian cancer(EOC)to improve preoperative imaging diagno-sis and differential diagnosis.Methods:A retrospective study was conducted on 42 patients with SO and 40 patients with stage Ⅰ EOC who underwent clinicopathological analysis.The clinical data,including symptoms,age,tumor biomarkers(CA125,HE4 and CA19-9)and imaging data,including location,number,size,shape,texture,the thickness of septic and cyst walls,CT density,MRI signal intensities,the degree,and pattern of enhancement were compared between the two groups.Multivariate logistic regression and ROC curve analysis were used to assess the association between clinical data and ima-ging features and to evaluate diagnostic performance.Results:Elevation of CA125(P＜0.001)and HE4(P＜0.001),postmenopausal vaginal bleeding(P＝0.005)were significantly different between the two groups.The differences in tumor texture,honeycomb loculi,wall nodule,cystic fluid density,solid components signal intensity,and enhancement degree were also statistically significant(P＜0.05).Ele-vation of CA125 and the degree of enhancement are independent predictors(P＝0.022,OR＝0.128;P＝0.002,OR＝11.148),with a combined diagnosis specificity of 90.0%.Conclusions:SO and stage ⅠEOC have different clinical symptoms,tumor biomarkers and imaging characteristics.The elevation of serum CA125 and the enhancement degree of solid components are independent predictors in the dif-ferential diagnosis of the two diseases.
关键词
卵巢甲状腺肿/上皮性卵巢癌/体层摄影术,X线计算机/磁共振成像Key words
Struma ovarii/Epithelial ovarian cancer/Tomography,X-ray computed/Magnetic resonance imaging引用本文复制引用
基金项目
上海市卫生健康委科研项目(20214Y0298)
出版年
2024
NETL
NSTL
维普
万方数据