经阴道超声和三维彩色血管能量成像单用及联用对宫颈癌分期的诊断效能研究  

Study On the Diagnostic Efficacy of Transvaginal Color Doppler Ultrasound and Three-Dimensional Color Power Angiography in the Staging of Cervical Cancer

作　　者：吴青京 陈昌钊 李波 吕立威 颜雪萍 Wu Qingjing;Chen Changzhao;Li Bo;Lü Liwei;Yan Xueping(Department of Ultrasound,Hainan Women and Children’s Mecical Center,Haikou 570206,China)

机构地区：[1]海南省妇女儿童医学中心超声科,海口市570206

出　　处：《中国超声医学杂志》2022年第1期87-91,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨经阴道彩色多普勒超声(TVCDS)、三维彩色血管能量成像(3D-PDUS)单用与联用对宫颈癌分期的诊断效能。方法选取宫颈癌患者(宫颈癌组)和健康女性(健康组)各68例,两组均接受TVCDS和3D-PDUS检查,比较两组的影像学特征差异。以宫颈癌的病理学分期结果为准,分析TVCDS、3D-PDUS单用与联用对各疾病分期的诊断效能。结果宫颈癌组的收缩期最大流速(PSV)、舒张末期流速(EDV)水平均高于健康组,血流阻力指数(RI)值均低于健康组(P<0.05)。宫颈癌组的血管形成指数(VI)、血流指数(FI)水平均明显低于健康组,血管形成-血流指数(VFI)水平明显高于健康组(P<0.05)。PSV、EDV、VI、FI、VFI、血流分级均随着疾病分期的升高而升高,RI随疾病分期的升高而降低,组间差异显著(P<0.05)。两项联合诊断宫颈癌Ⅰ期、Ⅱ期的曲线下面积(AUC)值分别为0.844和0.782,两项联合的诊断特异度明显高于两项单用(P<0.05)。两项联合对宫颈癌Ⅲ期的诊断灵敏度、特异度与TVCDS、3D-PDUS单用接近(P>0.05)。结论 3D-PDUS能够较好地反映宫颈病灶的新生血管数量及血供情况,联合TVCDS能有效提高Ⅰ~Ⅱ期宫颈癌的诊断效能。Objective To investigate the diagnostic efficacy of transvaginal color Doppler ultrasound(TVCDS) and three-dimensional color power angiography(3 D-PDUS) in the staging of cervical cancer. Methods There were 68 patients with cervical cancer(cervical cancer group) and 68 healthy women(healthy group).The patients of two groups were examined by TVCDS and 3 D-PDUS. The differences of imaging characteristics were compared between two groups. Based on the pathological staging results of cervical cancer, the diagnostic efficacy of TVCDS and 3 d-pdus alone and in combination was analyzed. Results The levels of peak systolic velocity(PSV) and end diastolic velocity(EDV) in cervical cancer group were higher than those in healthy group, and the resistance index(RI) values were lower than those in healthy group(P<0.05). The levels of vascularization index(VI) and flow index(FI) in cervical cancer group were significantly lower than those in healthy group, and the level of vascularization flow index(VFI) was significantly higher than that in healthy group(P<0.05). PSV, EDV, VI, FI, VFI and blood flow grade increased with the increase of disease stage, and RI decreased with the increase of disease stage(P<0.05). The area under curve(AUC) values of the combined methods were 0.844 and 0.782, respectively. The diagnostic specificity of the combined methods was significantly higher than that of the single methods(P<0.05). The sensitivity and specificity of the combination of TVCDS and 3 D-PDUS were similar to those of TVCDS and 3 D-PDUS alone(P>0.05). Conclusions 3 D-PDUS can better reflect the number of neovascularization and blood supply of cervical lesions, and TVCDS can effectively improve the diagnostic efficiency of stage Ⅰ-Ⅱ cervical cancer.

关 键 词：经阴道彩色多普勒超声 三维彩色血管能量成像 宫颈癌 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]