经阴道超声造影在宫颈癌术前诊断中的临床应用价值研究  

Clinical value of transvaginal contrast-enhanced sonography assessment preoperation diagnosis for cervical carcinoma

作　　者：王英娈[1] 王燕杰[2] 王秀芬[2] 杨春晓[3] 常洪波[1] 张海鹏[4] 郑力鹏[1] 董磊[5] 

机构地区：[1]临淄区人民医院超声科,山东淄博255400 [2]临淄区人民医院妇科,山东淄博255400 [3]临淄区人民医院肝胆外科,山东淄博255400 [4]临淄区人民医院病理科,山东淄博255400 [5]济南军区总医院超声科

出　　处：《中华临床医师杂志（电子版）》2013年第13期115-118,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨经阴道超声造影(TVS-CEUS)技术在宫颈癌术前诊断中的临床应用价值。方法回顾性分析31例宫颈癌患者的TVS-CEUS术前检查图像,未受累的宫颈、肌层及内膜作为对照,分析宫颈癌瘤体的造影声像图,评估局部病灶的性质、大小范围及术前分期,与术后病理结果进行比较。与正常肌层对比分析宫颈癌病灶TVS-CEUS的时间-增强曲线(TIC)形态及参数。结果 TVS-CEUS较常规TVS更能清晰显示病灶的边界,获得的病灶大小的测值更接近病理结果。正常子宫肌层与宫颈造影增强模式相同,TIC曲线参数差异无统计学意义(P>0.05),内膜的增强时间稍短,差异有统计学意义(P<0.05)。宫颈癌造影增强及消退早于正常肌层,增强强度高于正常肌层,其增强模式为"早进早退",不同分期的宫颈癌造影增强模式不同。宫颈癌病灶的TIC曲线参数造影剂显影时间(AT)、达峰时间(TTP)、增强时间(ET)、增强强度(EI)、上升斜率(RSR)、半洗出时间(HWOT)、下降早期斜率(HWSR)与对照组比较差异有统计学意义(P<0.05),对各参数进行ROC曲线分析得出对宫颈癌诊断能力较强的参数为RSR,界值为1.96 dB/s,灵敏度为100%,特异度为97.6%,Youden指数为97.6%。结论 TVS-CEUS在宫颈癌术前诊断中有较高的临床应用价值。Objective To explore the clinical value of TVS-CEUS in preoperative diagnosis of cervical cancer.Methods Preoperative TVS-CEUS imaging of 27 cases for cervical cancer were analyzed retrospectively , comparing with normal cervix, myometrium, endometrium.Contrast enhancement ultrasonography was analyzed to evaluate the quality,size,scope and preoperative staging for cervical lesion ,comparing the result of pathologic .The difference of lesions and normal myometrium enhancement patterns , and the time-intensity curves were analyzed . Results The boundary and the size of the lesion was more clearly displayed and more closed to the pathology results by TVS-CEUS than conventional TVS .The normal cervical and myometrium had the same contrast enhancement pattern,the difference of parameter TIC curve had not statistically significant （ P ＆gt;0.05 ） except the shorter of relatively rise time in endometrium （ P＆lt;0.05 ） .The cervical carcinoma had the early enhanced time and relatively rise in intensity than normal endometrium , discripted ‘early perfusion and wash-out′, various stages of cervical cancers had different enhancement pattern .In contrast parameters,contrast media arriving time,time to peak,relative rise time,relative rise in intensity,rising-slope rate,half wash-out time,half washed slope rate all have significant difference between cervical cancer and normal group （ P ＆lt;0.05 ） .Rising-slope rate was the best parameter for diagnosing cervical cancer , ROC curve showed the cut off values as 1.96 dB/s, the sensitivity was 100%, the specificity was 97.6%,Youden index was 97.6%.Conclusion TVS-CEUS has considerable value in preoperative diagnosis of cervical cancer .

关 键 词：子宫内膜肿瘤 经阴道超声 超声造影 术前诊断 

分 类 号：R737.33[医药卫生—肿瘤]