| 罗是是,王振平,刘富金,陈峰,李建军.原发性卵黄囊瘤CT表现[J].中国医学影像技术,2018,34(6):893~896 |
| 原发性卵黄囊瘤CT表现 |
| CT manifestations of primary yolk sac tumor |
| 投稿时间：2017-11-13 修订日期：2018-03-23 |
| DOI：10.13929/j.1003-3289.201711079 |
| 中文关键词: 卵黄囊 肿瘤 体层摄影术,X线计算机 |
| 英文关键词:Yolk sac Neoplasms Tomography, X-ray computed |
| 基金项目:国家临床重点专科建设项目经费资助（国卫办医函[2013]554号）。 |
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| 中文摘要: |
| 目的 探讨妇科超声影像报告和数据系统（GI-RADS）联合三维超声造影（3D-CEUS）鉴别诊断卵巢良恶性肿块的价值。方法 对102例卵巢肿块患者行二维超声及3D-CEUS检查，观察3D-CEUS灌注特征，并采用GI-RADS评估二维声像图表现。通过单因素χ2检验及多因素Logistic回归分析，获得卵巢恶性肿块的独立预测因子，构建GI-RADS与3D-CEUS联合评分系统。绘制ROC曲线，评价GI-RADS联合3D-CEUS与单纯应用GI-RADS诊断卵巢恶性肿块的效能，并进行比较。结果 单因素及多因素分析结果显示，卵巢恶性肿块的独立预测因子包括大乳头状突起物（≥ 7 mm）、分隔或囊壁厚度 ≥ 3 mm、有中心性血流、病灶实性成分 ≥ 50%，合并腹腔积液、高增强、造影剂分布不均匀以及血管密集、走行纡曲、杂乱。GI-RADS与3D-CEUS联合评分系统诊断卵巢恶性肿块的最佳临界值为4分，GI-RADS联合3D-CEUS的ROC曲线下面积大于单纯应用GI-RADS （0.969 vs 0.839，Z=1.64，P=0.029），且敏感度、特异度、阳性预测值、阴性预测值及准确率均高于单纯应用GI-RADS （P均<0.001）。结论 与单纯应用GI-RADS相比，GI-RADS联合3D-CEUS可更有效地鉴别卵巢良恶性肿块。 |
| 英文摘要: |
| Objective To observe CT features of primary yolk sac tumor (YST). Methods Clinical data and CT findings of 31 patients with primary YST proved by pathology were analyzed retrospectively. Plain CT was performed in 31 patients, while contrast enhanced CT scanning was performed in 23 patients. Results The lesions in 19 patients located in the gonads, including ovaries (n=11) and testes (n=8). Other lesions in 12 patients located out of gonads, including sacrococcygeal region (n=7), anterior mediastinum (n=3) and vagina (n=2). The tumors were oval shaped in 20 patients, while irregular shaped in other 11 patients. Well-defined boundary was found in 20 patients, whereas ill-defined boundary was found in 11 patients. Fat and calcification were found in 2 patients with teratomas. Moderate to marked enhancement of the solid part of tumors were observed in 23 patients, loofahs enhancement were observed in 17 patients, the blood vessels were found in 18 patients, while delayed enhancement of coated edge was found in 21 patients. The rupture of tumor capsule was found in 4 patients. Conclusion CT manifestations of YST have certain characteristics, which can provide imaging diagnostic evidences. |
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