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目的探讨多排螺旋CT(MDCT)对卵巢源性与非卵巢源性肿瘤的鉴别诊断价值。方法42例盆腔肿块患者术前行16排螺旋CT扫描,并行多平面重组(MPR)和曲面重组(CPR)。以术后病理诊断为标准,评价卵巢血管蒂征、病侧正常卵巢显示、盆腔肿块与输尿管的关系在卵巢源性与非卵巢源性肿瘤鉴别诊断中的价值。结果42例盆腔肿块中,术后病理诊断卵巢源性肿瘤28例,非卵巢源性肿瘤14例。以卵巢血管蒂征判断卵巢源性肿瘤的准确率为88.1%,敏感性为89.3%,特异性为85.7%,阳性预测值为92.6%,阴性预测值为80.0%。CPR可清楚显示卵巢血管蒂与盆腔肿块的关系。以病侧正常卵巢显示判断非卵巢源性肿瘤的准确率为83.3%,敏感性为50.0%,特异性为100.0%,阳性预测值为100.0%,阴性预测值为80.0%。卵巢血管蒂征及病侧正常卵巢是否存在对鉴别卵巢源性与非卵巢源性肿瘤均有统计学意义(P<0.01)。结论MDCT能清楚显示盆腔肿瘤与卵巢及卵巢血管蒂的关系,对鉴别卵巢源性与非卵巢源性肿瘤有重要价值。
Objective To investigate the differential diagnosis value of multi-slice spiral CT (MDCT) in ovarian and non-ovarian tumors. Methods 42 patients with pelvic mass underwent 16-slice spiral CT scan, parallel multiplanar reconstruction (MPR) and curved surface reconstruction (CPR). To postoperative pathological diagnosis as the standard evaluation of ovarian vasodilation, normal ovarian side showed pelvic masses and ureter in the differential diagnosis of ovarian and non-ovarian tumors in the value. Results Of 42 pelvic masses, 28 cases of ovarian tumors and 14 cases of non-ovarian tumors were diagnosed by pathology. The diagnostic accuracy of ovarian tumor was 88.1%, the sensitivity was 89.3%, the specificity was 85.7%, the positive predictive value was 92.6% and the negative predictive value was 80.0%. CPR can clearly show the relationship between ovarian vascular pedicle and pelvic mass. The accuracy of non-ovarian tumor was 83.3%. The sensitivity was 50.0%, the specificity was 100.0%, the positive predictive value was 100.0% and the negative predictive value was 80.0%. Ovarian vasodilatation and the presence of normal ovaries on the side of ovarian and non-ovarian cancer were identified statistically significant (P <0.01). Conclusion MDCT can clearly show the relationship between pelvic tumor and ovarian and ovarian pedicle, which has important value in distinguishing ovarian and non-ovarian tumors.