经阴道超高速剪切波弹性成像技术定量评价宫颈癌及癌前病变  

Transvaginal ultra high-speed shear wave elastography in quantitative evaluation of cervical carcinoma and cervical precancerous lesions

作　　者：李井平[1] 陈东风[2] 王少春[2] 李小花[2] 徐华[2] 杨林青[3] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]济宁医学院附属医院超声科,山东济宁272000 [3]济宁医学院附属医院妇科,山东济宁272000

出　　处：《中国医学影像技术》2016年第11期1706-1709,共4页Chinese Journal of Medical Imaging Technology

基　　金：济宁医学院附属医院"苗圃"科研计划项目(MP-2015-022)

摘　　要：目的探讨经阴道超高速剪切波弹性成像技术评价宫颈癌前病变及宫颈癌的价值。方法对150例宫颈病变患者(150个病灶)行经阴道超高速剪切波弹性成像检查,获得宫颈癌及癌前病变的弹性模量最大值和平均值,以病理为金标准,绘制ROC曲线以评价弹性参数诊断宫颈癌的诊断效能。结果病理诊断宫颈癌53例(53个病灶),癌前病变97例(97个病灶)。弹性模量最大值、平均值诊断宫颈癌的ROC曲线下面积分别为0.91、0.78(Z=3.53,P<0.05)。当弹性模量最大值和平均值分别以32.38kPa、30.16kPa作为诊断截断值时,诊断宫颈癌的敏感度、特异度、准确率分别为86.79%(46/53),90.72%(88/97),89.33%(134/150)和66.04%(35/53),80.41%(78/97),75.33%(113/150)。结论经阴道超高速剪切波弹性成像技术诊断宫颈癌有重要的价值,病灶的弹性模量最大值对宫颈癌的诊断价值大于弹性模量平均值。Objective To evaluate the value of quantitative elastography with ultra high-speed shear wave elasticity（SWE）in differential diagnosis of cervical precancerous lesions and cervical carcinoma.Methods Totally 150 patients with150cervical lesions underwent SWE quantitative elastography to obtain the maximum and mean elastic modulus value.ROC curves were used to assess the diagnostic performance of maximum and mean elastic modulus values.Results There were53 lesions in 53 cervical cancer patients and 97 lesions in 97 cervical precancerous patients.The areas under the ROC curve of the maximum and mean elastic modulus value were 0.91 and 0.78（Z =3.53,P〈0.05）,respectively.Taking32.38 kPa as a diagnostic cutoff value of the maximum elasticity value,the sensitivity,specificity,and accuracy in diagnosis of cervical cancer were 86.79%（46/53）,90.72%（88/97）,89.33%（134/150）,respectively.And taking 30.16 kPa as a diagnostic cutoff value of the mean elasticity value,the sensitivity,specificity,and accuracy in diagnosis of cervical cancer were 66.04%（35/53）,80.41%（78/97）,75.33%（113/150）,respectively.Conclusion SWE has significant value in the diagnosis of cervical cancer,and the diagnostic value of maximum elastic modulus is greater than that of the mean elastic modulus.

关 键 词：超声检查 超高速剪切波弹性成像 子宫肿瘤 宫颈癌前病变 

分 类 号：R737.33[医药卫生—肿瘤] R455.1[医药卫生—临床医学]