三维能量多普勒超声检测宫颈高级别鳞状上皮病变  

Three-dimensional power Doppler ultrasound in detection of cervical high grade squamous intraepithelial lesion

作　　者：张慧[1] 马琦[1] 李晓莹[1] 张爽[1] 侯文颖 孙立涛[1] 

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,黑龙江哈尔滨150086

出　　处：《中国医学影像技术》2016年第10期1545-1549,共5页Chinese Journal of Medical Imaging Technology

基　　金：黑龙江省博士后科研启动基金(LBH-Q13121)

摘　　要：目的前瞻性研究三维能量多普勒超声(3DPDUS)检测宫颈高级别鳞状上皮内病变(HSIL)的临床价值。方法收集120例疑似宫颈病变患者,排除宫颈有明显肿块者。对所有患者均行二维常规经阴道超声和3DPDUS检查,对照病理学结果进行分析。采用4Dview VOCAL软件获得宫颈三维血管参数,包括血管化指数(VI)、血流指数(FI)及血管化血流指数(VFI)。以病理结果为金标准,采用ROC曲线分析3DPDUS诊断HSIL的敏感度和特异度,并计算曲线下面积。结果 120例中,病理证实HSIL患者59例,二维超声诊断12例,3DPDUS诊断36例。HSIL患者的三维血管参数均高于宫颈良性病变患者,差异均有统计学意义(P均<0.05)。二维超声诊断HSIL的敏感度和特异度分别为20.33%(12/59)、75.40%(46/61),3DPDUS诊断HSIL的敏感度和特异度分别为61.01%(36/59)、81.96%(50/61)。ROC曲线分析显示当VI为3.38时,曲线下面积为0.883,特异度和敏感度分别为68.0%和72.9%,当FI为32.18时,曲线下面积为0.723,特异度和敏感度分别为68.2%和76.3%,当VFI为1.18时,曲线下面积为0.888,特异度和敏感度分别95.5%和72.9%。结论 VFI可用于临床早期鉴别宫颈HSIL。Objective To evaluate the clinical value of three-dimensional power Doppler ultrasound （3D PDUS） in detecting cervical high grade squamous intraepithelial lesion （HSIL）.Methods One hundred and twenty patients with suspected cervical lesions were enrolled, and underwent transvaginal ultrasound and 3D power Doppler ultrasound respectively. Patients with cervical mass were excluded. All the patients were confirmed by pathology. On 4D view VOCAL software, the following 3D PDUS indices were calculated, i.e. vascularization index （VI）, flow index （FI） and vascularization flow index （VFI）. Taking the pathological findings as golden standard, ROC curve was used to analysis the sensitivity and specificity of 3D PDUS in the diagnosis of HSIL, and area under curve （AUC） was calculated.Results Pathological examinations showed that 59 HSIL were included, among those 12 patients were diagnosed by transvaginal ultrasound and 36 patients were diagnosed by 3D PDUS, respectively. 3D PDUS indices of HSIL lesions were higher than that of benign lesions （all P〈0.05）. The sensitivity and specificity by transvaginal ultrasound were 20.33% （12/59） and 75.40% （46/61）. The sensitivity and specificity by 3D PDUS were 61.01% （36/59） and 81.96% （50/61）. The best cut-off value of VI was 3.38, AUC was 0.883, and the sensitivity and specificity were 72.9% and 68.0%, respectively. The best cut-off value of FI was 32.18, AUC was 0.723, and the sensitivity and specificity were 76.3% and 68.2%, respectively. The best cut-off value of VFI was 1.18, AUC was 0.888, and the sensitivity and specificity were 72.9% and 95.5%, respectively.Conclusion VFI can be used to the early detection of cervical HSIL.

关 键 词：宫颈高级别鳞状上皮病变 超声检查 多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.74[医药卫生—诊断学]