灰阶超声结合超声造影综合评分在子宫内膜病变诊断中的价值  

Value of comprehensive score of ultrasound combined with contrast-enhanced ultrasound in the diagnosis of endometrial lesions

作　　者：朱铖[1] 周海伟[2] 郑笑娟[1] 吴丽萍[3] 

机构地区：[1]浙江省舟山医院超声诊断中心,浙江舟山316000 [2]浙江省舟山医院放射诊断中心,浙江舟山316000 [3]浙江省舟山医院科教处,浙江舟山316000

出　　处：《中国现代医生》2017年第7期111-114,共4页China Modern Doctor

基　　金：浙江省科学技术厅课题(2016C33241);浙江省舟山市卫生局课题(2011A16)

摘　　要：目的探讨灰阶超声(ultrasound,US)结合超声造影(contrast-enhanced ultrasound,CEUS)综合评分在子宫内膜病变诊断中的应用价值。方法回顾性分析经病理证实的30例子宫内膜癌(endometrial carcinoma,EC)及30例良性病灶的CEUS声像图特征,将本次的子宫内膜癌的征象赋值为1,良性病灶的征象赋值为0,对各病例进行评分,以病理结果为金标准,构建受试者工作特征(receive operating characteristic,ROC)曲线,评价US结合CEUS综合评分在EC诊断中的实用价值,并计算其约登指数,预测最佳评分临界值。结果 US结合CEUS综合评分诊断EC的敏感度、特异度、阳性预测值及阴性预测值分别为90.00%(27/30)、83.33%(25/30)、84.38%(27/32)、89.29%(25/28)。US结合CEUS综合评分对诊断EC的ROC曲线下面积(area under the ROC curve,AUC)为0.939,95%的置信区间为0.859~0.949。以得分6分作为EC的诊断临界值时约登指数最高0.785,灵敏度、特异度、阳性预测值、阴性预测值分别为93.33%、86.67%、87.50%和92.86%。结论 US结合CEUS综合评分在EC诊断中意义较大,综合得分为6分可作为子宫内膜癌的诊断临界值。Objective To investigate the application value of ultrasound （US）combined with contrast-enhanced ultrasound （CEUS）in the diagnosis of endometrial lesions. Methods Uhrasonogram characteristics of CEUS of 30 patients with endometrial carcinoma（EC）confirmed pathologically and 30 cases of benign lesions were retrospectively analyzed. The sign of the endometrial cancer was assigned a value of 1, and the sign of benign lesion was assigned a value of 0. Each case was scored, and the receiver operating characteristic （ROC）curve was constructed by using the pathological results as the golden standard. The practical value of comprehensive score of US combined with CEUS in the diagnosis of EC was evaluated, and the Y^uden index was calculated to predict the best critical value of score. Results The sen- sitivity, specificity, positive predictive value and negative predictive value of comprehensive score of US combined with CEUS in the diagnosis of EC were 90.00% （27/30）, 83.33% （25/30）, 84.38% （27/32） and 89.29% （25/28）. The area under the ROC eurve（AUC） of comprehensive score of US combined with CEUS in the diagnosis of EC was 0.939, and the 95% confidence interval was 0.859-0.949. When the diagnostic critical value of EC was scored at 6, Youden index was the highest at 0.785. The sensitivity, specificity, positive predictive value and negative predictive value were 93.33%,86.67%,87.50% and 92.86% respectively. Conclusion Comprehensive score of US combined with CEUS has a great significant in the diagnosis of EC. The Comprehensive score of 6 can be used as the diagnostic critical value of endometrial cancer.

关 键 词：超声检查 超声造影 子宫内膜癌 评分 

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]