经直肠腔内超声与剪切波弹性成像在直肠癌诊断中的对比研究  

Comparative study of endorectal ultrasound and shear wave elastography in the diagnosis of rectal cancer

作　　者：陈晓琼[1] 王月爱[1] 李波[2] CHEN Xiaoqiong;WANG Yue’ai;LI Bo(Department of Ultrasound Imaging,the First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院超声影像科,长沙市410007 [2]湖南中医药大学第一附属医院放射科,长沙市410007

出　　处：《临床超声医学杂志》2022年第3期235-238,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的比较经直肠腔内超声(ERUS)与剪切波弹性成像(SWE)在直肠癌诊断中的应用价值。方法选取我院经病理确诊的128例直肠肿瘤患者,其中直肠癌68例(恶性组),直肠腺瘤60例(良性组),两组均行ERUS和SWE检查,比较动脉血流阻力指数(RI)、搏动指数(PI)、收缩期血流峰值流速(PSV)、舒张末期血流速度(EDV)、杨氏模量均值(Emean)的差异。绘制受试者工作特征(ROC)曲线评估RI、PI、PSV、EDV、Emean对直肠癌的诊断效能。结果恶性组RI、PI均低于良性组,PSV、EDV、Emean均高于良性组,差异均有统计学意义(均P<0.05)。直肠癌T1、T2、T3、T4期RI、PI、PSV、EDV、Emean比较,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,RI、PI、PSV、EDV、Emean诊断直肠癌的曲线下面积分别为0.914、0.747、0.666、0.839、0.996,敏感性分别为88.2%、48.5%、72.1%、64.7%、100%,特异性分别为83.3%、100%、56.7%、95.0%、93.3%。Emean的曲线下面积与RI、PI、PSV、EDV比较差异均有统计学意义(Z=3.390、5.646、6.862、4.346,均P<0.001)。结论SWE较ERUS在直肠癌诊断方面可能具有更高的临床应用价值。Objective To compare the application value of endorectal ultrasound(ERUS)and shear wave elastography(SWE)in the diagnosis of rectal cancer.Methods A total of 128 patients with rectal tumor diagnosed by pathological biopsy in our hospital were selected,including 68 patients with rectal cancer(malignant group)and 60 patients with rectal adenoma(benign group).Both groups underwent ERUS and SWE examinations,the arterial blood flow resistance index(RI),pulsatility index(PI),peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV)and Emean were compared.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of RI,PI,PSV,EDV and Emean for rectal cancer.Results Emean were higher than those in the benign group,and the differences were statistically significant(all P<0.05).The differences in RI,PI,PSV,EDV and Emean of rectal cancer in T1,T2,T3 and T4 stages were statistically significant(all P<0.05).ROC curve analysis showed that the area under curve(AUC)of RI,PI,PSV,EDV and Emean for diagnosing rectal cancer were 0.914,0.747,0.666,0.839 and 0.996,respectively,the sensitivities were 88.2%,48.5%,72.1%,64.7%and 100%,respectively,the specificities were 83.3%,100%,56.7%,95.0%and 93.3%,respectively.There were significant differences of AUCs between Emean and RI,PI,PSV,EDV(Z=3.390,5.646,6.862,4.346,all P<0.001).Conclusion Compared with ERUS,SWE may has higher clinical application value in the diagnosis of rectal cancer.

关 键 词：超声检查 经直肠 剪切波弹性成像 血流动力学 直肠肿瘤 恶性 T分期 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.3[医药卫生—诊断学]