二维超声及声脉冲辐射力弹性成像技术在卵巢癌术前分期中应用价值  

Two-dimensional ultrasound and acoustic radiation force impulse elastography in preoperative staging of ovarian cancer

作　　者：肖艳菊[1] 郑红雨[1] 杜阳春[1] 康利克[1] 黄雍 XIAO Yan-ju;ZHENG Hong-yu;DU Yang-chun;KANG Li-ke;HUANG Yong(Department of Ultrasound,People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi Zhuang Autonomous Region 530021,China)

机构地区：[1]广西壮族自治区人民医院超声科,广西壮族自治区南宁530021

出　　处：《中华实用诊断与治疗杂志》2021年第8期848-850,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：广西科学研究与技术开发计划项目(桂科攻14279010);南宁市青秀区科学研究与技术开发计划项目(2015S07)。

摘　　要：目的探讨二维超声、声脉冲辐射力弹性成像(acoustic radiation force impulse,ARFI)技术在卵巢癌术前分期诊断中的应用价值及剪切波传播速度(shear wave velocity,SWV)对卵巢癌分期诊断的临床意义。方法62例卵巢癌患者术前均行二维超声检查,并采用ARFI技术测量病灶处SWV;以组织病理检查结果为金标准,分析术前二维超声分期对卵巢癌的诊断效能;采用Spearman等级相关性分析卵巢癌患者病灶SWV值与组织病理分期的相关性。结果62例卵巢癌组织病理分期Ⅰ期9例,Ⅱ期30例,Ⅲ期13例,Ⅳ期10例。超声检查对病理分期Ⅰ~Ⅳ期卵巢癌诊断的灵敏度分别为55.6%、53.3%、53.8%、50.0%,特异度分别为81.1%、84.4%、79.6%、92.3%,准确率分别为77.4%、69.4%、74.2%、85.5%。卵巢癌Ⅳ期患者病灶SWV值[(4.43±0.27)m/s]大于Ⅰ期[(1.57±0.09)m/s)]、Ⅱ期[(2.22±0.37)m/s]、Ⅲ期[(3.67±0.18)m/s](P<0.05),Ⅲ期大于Ⅱ期、Ⅰ期(P<0.05),Ⅱ期大于Ⅰ期(P<0.05);卵巢癌患者病灶SWV值与组织病理分期呈正相关(r=0.933,P<0.001)。结论二维超声检查可为卵巢癌术前初步分期提供参考;ARFI技术测量卵巢癌病灶SWV值可为卵巢癌术前分期提供有价值信息,SWV值越大,提示组织病理分期越晚。Objective To investigate the values of two-dimensional ultrasound and acoustic radiation force impulse(ARFI)elastography to the staging diagnosis of ovarian cancer before operation,and the clinical significance of shear wave velocity(SWV)in the staging of ovarian cancer.Methods Sixty-two patients with ovarian cancer received two-dimensional ultrasonography before operation,and ARFI elastography was used to measure the SWV.The diagnostic efficiency of two-dimensional ultrasound staging on the diagnosis of ovarian cancer was analyzed with postoperative histopathological results as the gold standard.Spearman rank correlation was used to analyze the correlation between SWV and histopathological stage of ovarian cancer.Results In 62 patients,there were 9,30,13 and 10 patients in stageⅠ,Ⅱ,ⅢandⅣ,respectively.The sensitivities of ultrasonography to the diagnosis of ovarian cancer in stageⅠtoⅣwere 55.6%,53.3%,53.8%and 50.0%,the specificities were 81.1%,84.4%,79.6%and 92.3%,and the accuracies were 77.4%,69.4%,74.2%and 85.5%,respectively.The SWV was greater in patients with stageⅣovarian cancer((4.43±0.27)m/s)than that in patients with stageⅠovarian cancer((1.57±0.09)m/s),stageⅡ((2.22±0.37)m/s),stageⅢ((3.67±0.18)m/s)(P<0.05),higher in stageⅢthan that in stageⅡandⅠ(P<0.05),and higher in stageⅡthan that in stageⅠ(P<0.05).The SWV was positively correlated with the histopathological stage of ovarian cancer(r=0.933,P<0.001).Conclusion Two-dimensional ultrasonography can provide a reference for the preoperative preliminary staging of ovarian cancer.The SWV measured by ARFI elastography is of great clinical significance in the diagnosis and histopathological staging of ovarian cancer.The greater the SWV value,the more advanced the histopathological stage.

关 键 词：卵巢癌 超声检查 声脉冲辐射力弹性成像技术 剪切波传播速度 组织病理分期 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]