摘要
目的探讨超声对腹腔浆膜腔积液良恶性的鉴别诊断价值。方法选取我院腹腔浆膜腔积液患者104例,其中良性37例,恶性67例。比较良、恶性浆膜腔积液患者的腹腔超声特征;采用Logistic回归模型分析差异有统计学意义的主要诊断指标,分析其对恶性浆膜腔积液的诊断效能。结果良、恶性浆膜腔积液患者的胆囊壁厚度、后腹膜淋巴结肿大、肠管浮游、大网膜增厚/结节、大网膜血流情况及肠壁增厚比较差异均有统计学意义(均P<0.05)。经过二变量Logistic逐步回归,得到以下方程:恶性可能性=1/(1+e^(-z)),其中z=4.226×胆囊壁厚度+5.218×大网膜增厚/结节+3.024×肠壁增厚+4.892×肠管浮游-29.387;大网膜增厚/结节诊断恶性浆膜腔积液的OR值为7.375,高于其他自变量。当浆膜腔积液患者出现胆囊壁薄、大网膜增厚/结节、肠壁增厚,且肠管浮游征消失时,恶性可能性为99%。结论超声有助于浆膜腔积液良恶性的鉴别诊断;且胆囊壁厚度、大网膜增厚/结节、肠壁增厚及肠管浮游征是超声预测浆膜腔积液良恶性的有效特征指标。
Objective To explore the application value of ultrasound in differential diagnosis of benign and malignant serous effusion.Methods A total of104patients with serous effusion of our hospital were recruited in the study,including37cases of benign and67cases of malignant.The ultrasonic features were compared between the benign and malignant serous effusions.Logistic regression model was used to screen out the main diagnostic indicators which had statistical significance,and to establish the formula to calculate the possibility of malignancy.Results The gallbladder wall thickness,swollen retroperitoneal lymph node,floating bowel,greater omental thickening/nodules,blood flow of greater omentum and intestinal wall thickening in patients with benign and malignant serous effusions were statistically significant(all P<0.05).The following formula were obtained by two-variable logistic regression model:malignancy possibility=1/(1+e-z),which z=4.226×gallbladder wall thickness+5.218×greater omental thickening/nodules+3.024×intestinal wall thickening+4.892×floating bowel-29.387.The OR value of the greater omental thickening/nodules was higher than other independent variables.When the serous effusion in patients with gallbladder wall thinness,greater omental thickening/nodules,intestinal wall thickening and floating bowel disappear,the possibility of malignancy was99%.Conclusion Gallbladder wall thickness,greater omental thickening/nodules,intestinal wall thickening and floating bowel are useful indicators for predicting benign and malignant serous effusions.
作者
姜智明
林燕
邵菊
JIANG Zhiming;LIN Yan;SHAO Ju(Department of Ultrasound, the Sixth People 's Hospital of Nantong, Jiangsu 226011, China)
出处
《临床超声医学杂志》
2018年第3期177-180,共4页
Journal of Clinical Ultrasound in Medicine
