Značaj ultrasonografije u detekciji neoangiogeneze adneksalnih masa
The importance of ultrasonography in the detection of neoagiogenesis in adnexal mases
Author
Maglić, Rastko K.Mentor
Nikolić, BrankaCommittee members
Rakić, SnežanaPažin, Vladimir
Ilić, Đorđe
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Show full item recordAbstract
Predmet istraživanja je određivanje specifičnosti i senzitivnost transvaginalnog
ultrasonografskog pregleda, 3D multislice pregleda i color dopplera u diferencijaciji
adneksalnih tumorskih masa. Procena je obavljena na osnovu merenja indeksa otpora (Ri)
u krvnim sudovima na periferiji tumora ili u tumoru ukoliko su prisutni, (solidna
komponenta) indexa otpora (Ri) obe jajničke arterije i indexa otpora obostrane uterine
arterije. Određena je specifičnost i senzitivnost ove tehnike uz poređenje nalaza sa
operativnim i patohistološkim nalazom. Ispitane su serumske vrednosti tumor markera
CA125 i HE4 da bi utvrdili njihov značaj u diferencijalnoj dijagnozi adneksalnih masa.
Na osnovu urađenih ultrasonografskih transvaginalnih, color doppler i 3D analiza
formirana je osnova dopunjenog algoritna, na osnovi IOTA jednostavnih pravila sa kojim
se na jednostavan način može napraviti diferencijacija adneksalnih tumorskih masa
CILJ RADA:
• Odrediti senzitivnost i specifičnost transvaginalne ultras...onografske detekcije
neoangiogeneze u dijagnostici adneksalnog nalaza.
• Ispitati značaj uključivanja vrednosti serumskih tumor markera u određivanju
prediktivne vrednosti ultrazvučnog nalaza u diferencijalnoj dijagnozi adnexalnih masa.
• Formiranje algoritma za dijagnostiku adneksalnih tumora na osnovu IOTA
algoritma jednostavnih pravila, transvaginalnog mapiranja angiogeneze putem 3D color
dopler ultrazvuka i analize ultrazvučne slike i vrednosti serumskih tumor markera.
METODOLOGIJA:
Ispitivanje sprovedeno kao studija preseka, koja je uključila sve pacijetnkinje koje
ispunjavanju kriterijum za uključivanje u studiju a operisane su u klinici GAK „Narodni
front“, u periodu od 1.8.2014. do 1.5.2016. godine. Istraživanje je odobreno od etičke
komisije Medicinskog fakulteta Univerziteta u Beogradu i etičkog odbora Klinike GAK
“Narodni Front”. Svim pacijentkinjama je dato detaljno i precizno usmeno i pismeno
objašnjenje o cilju i značaju ispitivanja i planiranim dijagnostičkim postupcima i lečenju.
Potvrdile su svoju saglasnost za dobrovoljno učestvovanje u istraživanju. Od analitičkih
metoda korišteni su Hi kvadrat test za procenu značajnosti razlike multivariacione analize
varijanse (MANOVA), neparametarska jednofazna ANOVA i Krusskal-Wallisov test...
The object of this research is to establish the sensitivity and specificity of the transvaginal
ultrasound exam, 3D multislice analysis and color Doppler investigation in the
differentiation of adnexal mases. The evaluation was done by measuring Resistance
indexes (Ri) in blood vessels on the surface of the adnexal tumors or inside the solid
adnexal mases if present and resistance indexes in the ovarian and uterine artery of the
ipsilateral side. The specificity and sensitivity of the technique was established
comparing the results with operative histology. Serum values of tumor marker CA125
and HE4 were examined in these patients to establish their correlation, or lack of it, with
differential diagnosis of adnexal mases. Based upon the transvaginal ultrasound
examination and 2D and 3D neovascularization analysis, a basis for an improved IOTA
simple rules algorithm was formed. This provides the future researcher with an easily
reproducible tool for the differentiation of adnexal tumor ...mases.
THE GOALS:
• To establish the sensitivity and specificity of transvaginal ultrasonography in the
detection of neoangiogenesis in adnexal mases.
• To investigate the benefits of possible inclusion of serum tumor markers values
(Ca 125 and HE4) in establishing the predictive value of the ultrasound examination of
• To establish an improved IOTA simple rules algorithm adding transvaginal color
Doppler ultrasound 2D and 3D angiogenesis mapping and flow analysis to improve the
predictive value in differentiating adnexal mases.
METHODS:
The research was conducted as a cross section study, including all patients fulfilling the
study inclusion criteria, and admitted for treatment in the Gyn and Obs University Clinic
„Narodni front“, between 1.8.2014. until 1.5.2016. The study was approved by the ethics
board of the Medical faculty of the University of Belgrade and the ethics board of the
Gyn and Obs University Clinic „Narodni front“. All patients were given a detailed written
explanation of the study and answered all questions involving the details of the study,
treatment, procedures and surgeries involved. All of them knowingly agreed to
voluntarily take art in the study.
Statistical data was analysed using Hi square test to evaluate the significance of difference
in multivariate analysis of variance (MANOVA), single phase non-parametrical analysis
ANOVA and Kruskal-Wallis test...