超声造影诊断盆腔包块及误诊原因分析-影像医学与核医学专业论文.docxVIP

新疆医科大 新疆医科大学硕士学位论文 PAGE PAGE 1 超声造影诊断盆腔包块及误诊原因分析 研究生：刘娟 导师：向红副教授 摘 要 目的：探讨超声造影对盆腔包块的诊断及误诊原因分析，以提高超声造影对盆 腔包块的正确诊断率。方法：采用超声造影剂 SonoVue 联合造影匹配成像技术对 91 例妇科盆腔包块进行实时超声造影检查。观察盆腔包块的造影剂灌注过程及造影后 声像图特征并分析时间强度曲线，其诊断结果分别与金标准对照；同时对超声造影 误诊盆腔包块 25 例进行回顾性分析。结果：盆腔良恶性肿瘤超声造影表现不同，良 性包块均匀增强，多从周边向内部灌注；恶性肿瘤不均匀增强，多以血管为中心向 内部灌注。时间强度曲线形态特征：良性组总体形态呈“缓升缓降”、恶性组总体形 态呈“速升速降型”，两组之间比较差异有统计学意义（P＜0.05）。时间强度曲线参数： 恶性组的始增时间、达峰时间早于良性组，两组之间比较差异有显著性（P＜0.05）， 但峰值强度两组之间比较无差异性。超声造影诊断盆腔包块灵敏度分别为 87.5%，特 异度分别为 94.0%。误诊 25 例中：1）良性病变误诊为恶性肿瘤 5 例（5∕25）；2） 恶性肿瘤误诊为良性病变 1 例（1∕25）；3）良性病变判断不准确 9 例（9∕25）；4） 病变定位错误 10 例（10∕25）。结论：超声造影在揭示肿瘤的血流灌注特征方面更 具优越性，但仍需与二维超声图像综合分析，同时密切结合临床，仔细辨析造影图 像，是减少误诊的重要环节。 关键词：超声造影； 盆腔包块； 误诊 Contrast-enhanced Ultrasound in Diagnosis and Misdiagnosed Analysis of Pelvic masses Postgraduate: LiuJuan Superisor: Associate prof. Xiang Hong Abstract Objective: To investigate the reasons of diagnosis and misdiagnosed analysis of pelvic masses by Contrast-enhanced Ultrasound in order to improve diagnostic accuracy. Methods: 91 cases of pelvic masses were examined by ultrasound contrast agents of SonoVue combined with contrast tuned imaging (CnTI). The perfusion process and sonographic characteristics of pelvic masses were observed; the enhanced parameters of masses were analyzed with time-intensity curve (TIC). The diagnosis result compared with the gold standards; and then contrast-enhanced ultrasound misdiagnosed pelvic masses of 25 cases were retrospectively reviewed. Results: The enhancement appearance of contrast-enhanced ultrasound for malianant tumors and benign masses in different, the benign masses appear the enhancement of contrast agent regularly form periphery into centre, while malignant tumors appear the enhancement irregularly on vascular as centre.The curve appeared slow-up and slow-down type in the benign group, but quick-up and quick-down type in the malignant group, and have statistical significance among the two groups (P＜0.05). The arrival time and time to peak intensity was shor