经阴道超声在宫颈癌诊断中的价值(附177例病例分析及文献复习)  

Diagnostic value of transvaginal ultrasound for cervical carcinoma:a report of 177 cases and a literature review

作　　者：邵茵[1,2] 李明娥 马利国[1,2] 张金玲 张琳[1,2] 

机构地区：[1]暨南大学第二临床医学院 [2]深圳市人民医院妇科,深圳518020

出　　处：《山西医科大学学报》2010年第6期550-552,共3页Journal of Shanxi Medical University

摘　　要：目的探讨经阴道超声在宫颈癌临床诊断中的价值。方法回顾性分析我院1998-08～2008-04经手术及病理确诊并于术前行阴道超声检查的宫颈癌患者177例,分析其阴道超声的声像图特征,总结阴道超声与手术病理分期的符合情况。结果 177例宫颈癌患者中86例患者呈现正常宫颈声像图,91例患者呈现异常宫颈声像图,主要以宫颈实质性低回声肿块、宫颈均匀性或非均匀性增大以及界限欠清的不均质回声为主。对照手术病理分期,经阴道超声对于宫颈癌总的阳性预测值为51.41%(91/177),Ⅰ期为45.21%(66/146),Ⅱ期以上(含Ⅱ期)为80.65%(25/31)。其中仅2例提示宫旁组织结构模糊,1例患者经阴道超声提示宫体下段受累,余各病例均未提示周围脏器浸润情况;有63例(35.59%)患者阴道超声符合宫颈癌的彩色血流动力学声像图表现。结论经阴道超声在宫颈癌的诊断中,尤其是宫颈的分期诊断中有一定的局限性,临床价值有限。Objective To explore the clinical diagnostic value of transvaginal ultrasound（TVUS）for cervical carcinoma. Methods The medical records of 177 patients with cervical carcinoma examined with TVUS before surgery in our hospital from August 1998 to April 2008 were retrospectively reviewed.The reliability of TVUS was evaluated by analyzing the features of sonogram and compared with the pathological staging. Results Among 177 cases,86 cases showed normal sonographic features,and the others（91 cases）showed abnormal imagings,in which the tumors mainly appeared as hypoechoic parenchymal mass,homogeneous or heterogeneous enlargement of cervix or heterogeneous lession with undefined borders.Compared with the surgical pathological staging,the positive predictive rate of TVUS staging was 51.41% for all the patients,45.21% at stage Ⅰ and 80.56% at stage Ⅱ.Only two cases showed the parametrial involvement.One case was involved in the lower part of uterus.And no other infiltration of adjacent tissues was found. Conclusion Transvaginal ultrasound has limitation in the diagnosis of cervical carcinoma,especially in the evaluation of staging.

关 键 词：经阴道超声 宫颈癌 分期诊断 

分 类 号：R737.33[医药卫生—肿瘤]