TVS-CEUS在宫颈癌术前临床分期诊断中的可行性研究  

Feasibility study of TVS-CEUS in preoperative clinical staging diagnosis of cervical cancer

作　　者：王英娈 刘颖 王来栋 崔艳玲 杨春晓 张海鹏 WANG Yingluan;LIU Ying;WANG Laidong;CUI Yanling;YANG Chunxiao;ZHANG Haipeng(Department of Ultrasound,Zibo Municipal Hospital,Shandong Province,Zibo 255400,China;Department of Gynecology,Zibo Municipal Hospital,Shandong Province,Zibo 255400,China;Ward Five,Department of General Surgery(Two Glands),Zibo Municipal Hospital,Shandong Province,Zibo 255400,China;Department of Pathology,Zibo Municipal Hospital,Shandong Province,Zibo 255400,China)

机构地区：[1]山东省淄博市市立医院超声科,山东淄博255400 [2]山东省淄博市市立医院妇科,山东淄博255400 [3]山东省淄博市市立医院普外科五病区(两腺),山东淄博255400 [4]山东省淄博市市立医院病理科,山东淄博255400

出　　处：《中国医药导报》2022年第22期149-152,共4页China Medical Herald

基　　金：北京医学奖励基金会课题研究项目(YXJL201906880046);山东省淄博市科学技术发展计划政策引导类项目(2014kj060020)。

摘　　要：目的评估经阴道超声造影(TVS-CEUS)技术在宫颈癌术前诊断及临床分期中的应用价值,并探讨行临床分期的可行性。方法选取2011年9月至2020年12月于山东省淄博市市立医院就诊且经手术病理证实的81例宫颈癌患者。所有患者术前均行经阴道彩色多普勒超声(TVCDS)及TVS-CEUS检查,评估病灶的性质并进行术前分期;观察良恶性淋巴结之间的图像差异。结果TVS-CEUS宫颈癌检出率高于TVCDS,差异有统计学意义(P<0.05)。TVCDS诊断符合率为73.08%(57/78),Kappa值为0.536;TVS-CEUS诊断符合率为89.74%(70/78),Kappa值为0.824。盆腔转移淋巴结的声像表现为造影剂显像迟于周围正常软组织,呈弥漫性均匀低增强,且与周围组织无明显界限。结论TVS-CEUS提高了对宫颈癌的诊断能力及分期的准确性,对盆腔肿大淋巴结的性质判定也有一定价值。Objective To evaluate the value of transvaginal contrast-enhanced ultrasound(TVS-CEUS)in preoperative diagnosis and clinical staging of cervical cancer,and to explore the feasibility of clinical staging.Methods A total of 81 patients with cervical cancer confirmed by surgery and pathology were selected from September 2011 to December 2020 in Zibo Municipal Hospital of Shandong Province.All patients underwent transvaginal color Doppler ultrasound(TVCDS)and TVS-CEUS examination before surgery to evaluate the nature of lesions and perform preoperative staging;the differences between benign and malignant lymph nodes were observed.Results The detection rate of cervical cancer of TVS-CEUS was higher than that of TVCDS,and the difference was statistically significant(P<0.05).The diagnostic coincidence rate of TVCDS was 73.08%(57/78),and Kappa value was 0.536;the diagnostic coincidence rate of TVS-CEUS was 89.74%(70/78),and Kappa value was 0.824.The sonographic appearance of pelvic metastatic lymph nodes was later than the surrounding normal soft tissue with diffuse uniform low enhancement and no clear boundary with the surrounding tissue.Conclusion TVS-CEUS can improve the diagnostic ability and staging accuracy of cervical cancer,and has certain value in the determination of the nature of pelvic enlarged lymph nodes.

关 键 词：宫颈癌 经阴道超声 超声造影 分期诊断 

分 类 号：R737.33[医药卫生—肿瘤]