经阴道超声实时弹性成像对宫颈癌诊断的临床价值评价  

The clinical value of the real-time transvaginal ultrasound elastography for the diagnosis incervical cancer

作　　者：马希[1] 丁伟[1] 张厚胜[1] 王红燕[1] 李祁[1] 邵军[1] MA Xi, DING Wei, ZHANG Hou-sheng, WANG Hong-yan, LI Qi, SHAO Jun(Department of Ultrasound Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan 215300, Chin)

机构地区：[1]江苏大学附属昆山医院超声科,江苏昆山215300

出　　处：《现代医学》2018年第3期255-258,共4页Modern Medical Journal

基　　金：昆山市社会发展科技专项课题(KS1733)

摘　　要：目的:分析宫颈癌超声弹性成像(ultrasound elastography,UE)的声像图特征,探讨经阴道超声实时弹性成像技术中弹性评分法、应变率比值法在宫颈癌诊断中的价值。方法:对疑诊宫颈病变的84例女性患者行经阴道超声弹性成像检查,获得弹性评分和应变率比值,以病理诊断结果为金标准,应用ROC曲线来评价弹性评分法、应变率比值法对宫颈癌的诊断效能。结果:超声弹性评分法与应变率比值法诊断宫颈癌受试者工作特征曲线(ROC曲线)下面积分别为0.79、0.809(P<0.05),当超声弹性评分与应变率比值最佳截断值为4和3.22时对宫颈癌诊断的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为64.9%(24/37)、78.7%(37/47)、72.6%(61/84)、70.6%(24/34)、74%(37/50)和70.3%(26/37)、80.9%(38/47)、76.2%(64/84)、74.3%(26/35)、77.6%(38/49)。结论:经阴道实时超声弹性成像中弹性评分法、应变率比值法对宫颈癌均有较好的诊断价值,可作为临床宫颈癌筛查和诊断中的有益弥补;应变率比值法作为半定量诊断方法,其敏感度、特异度、准确度高于弹性评分法。Objective： To investigate the diagnostic performance of transvaginal ultrasound elastography（ TVES）for cervical cancer,including elasticity score and strain ratio method,then explore the diagnose value of TVES.Methods： Totally 84 patients with cervical lesions underwent TVES,elasticity score and strain ratio were obtained before treatment,ROC curves were used to assess the diagnostic performance of TVES. Results： The areas under the ROC curve of elastic score method and strain ratio method were 0. 79,0. 809（ P〈0. 05）,respectively. Taking4 as a diagnostic cutoff value of the elastographic score value and 3. 22 as a diagnostic cutoff of the strain ratio value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 64. 9%（ 24/37）,78. 7%（ 37/47）,72. 6%（ 61/84）,70. 6%（ 24/34）,74%（ 37/50） and 70. 3%（ 26/37）,80. 9%（ 38/47）,76. 2%（ 64/84）,74. 3%（ 26/35）,77. 6%（ 38/49）,respectively. Conclusion： The elastic score method and strain ratio method in TVES have a certain diagnostic value for cervical cancer,TVES can be used as a useful supplement to the screening and diagnosis of cervical cancer. The strain ratio as a semi-quantitative diagnostic method,it＇s sensitivity,specificity,accuracy are slightly higher than those of the elastic score method.

关 键 词：经阴道超声 弹性成像 宫颈癌 弹性评分 应变率比值 

分 类 号：R445.1[医药卫生—影像医学与核医学]