宫颈鳞癌与宫颈腺癌的超声表现和鉴别诊断  

Ultrasonographic manifestations and differential diagnosis of cervical squamous cell carcinoma and cervical adenocarcinoma

作　　者：廖平川[1] 李风艳[2] 翟瑞芳[2] 韩蓉晖[3] 李苏芬 闫雅茹 LIAO Pingchuan;LI Fengyan;ZHAI Ruifang;HAN Ronghui;LI Sufen;YAN Yaru(Emergency Medical Center,First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Gynecology,First Hospital of Shanxi Medical University;Department of Gynecological Pathology Center,First Hospital of Shanxi Medical University)

机构地区：[1]山西医科大学第一医院急诊医学中心,太原030001 [2]山西医科大学第一医院妇科 [3]山西医科大学第一医院妇科病理室

出　　处：《山西医科大学学报》2022年第12期1606-1609,共4页Journal of Shanxi Medical University

摘　　要：目的利用超声检查技术探讨宫颈鳞癌和宫颈腺癌的相关声像图特征,以期达到对二者的鉴别。方法本组以经阴道超声检查为主、经腹部超声检查为辅随机检查和评估宫颈癌共计23例,根据子宫颈二维回声强弱、彩色多普勒血流充盈程度(预先统一设定超声测量标准)以及频谱多普勒测量阻力指数高低等相关指标,超声预先报告宫颈鳞癌或宫颈腺癌可能,之后与病理报告结果对照,若结果一致认为超声诊断准确,否则为不准确。结果经超声观察和分析发现,宫颈可疑病灶范围≥1.0 cm×0.5 cm,且以低回声为主,同时血流信号充盈达较丰富或极丰富等级,阻力指数≤0.5时超声即可报告宫颈鳞癌可能,本组超声共计报告18例,经病理报告证实16例,超声报告准确性88.9%。若超声测量病灶范围大于1.5 cm×1.0 cm,且以高回声为主,血流充盈达较丰富或极丰富等级,阻力指数≤0.5时超声即可报告宫颈腺癌可能,本组超声报告宫颈腺癌共计5例,均经病理报告证实。结论超声检查对于宫颈鳞癌及宫颈腺癌均有各自的声像图表现特点,故超声检查对于宫颈鳞癌和腺癌有着重要的鉴别诊断价值。Objective To explore the sonographic features of cervical squamous cell carcinoma and cervical adenocarcinoma by ultrasonic examination technology for their differential diagnosis.Methods A total of 23 cases of cervical cancer were randomly examined and evaluated by transvaginal ultrasound assisted with transabdominal ultrasound.According to the echo intensity of two-dimensional image of the cervix,the degree of color Doppler blood flow filling(a unified ultrasound measurement standard was set in advance),and the resistance index measured by spectral Doppler,the opportunity of cervical squamous carcinoma or cervical adenocarcinoma was stated.If the consequences are consistent with the pathological diagnosis,the ultrasonic analysis is accurate,in any other case it is inaccurate.Results Based on ultrasonic observation and analysis,the case was reported as cervical squamous cell carcinoma when the range of suspected cervical lesions was greater than or equal to 1.0 cm×0.5 cm,low echo was dominant,the blood flow filling reached a relatively rich or extremely rich level,the resistance index was less than or equal to 0.5.In this group,16 of 18 cases reported by ultrasound were confirmed by pathology,and the accuracy of ultrasound report was 88.9%.The possibility of cervical adenocarcinoma was reported by ultrasound when the scope of the lesions was greater than 1.5 cm×1.0 cm,the echo was mainly hyperechoic,the blood flow filling reached a relatively rich or extremely rich level,and the resistance index was less than or equal to 0.5.All 5 cases of cervical adenocarcinoma reported by ultrasound in this group were confirmed by pathological reports.Conclusion Cervical squamous cell carcinoma and cervical adenocarcinoma have their own sonographic features by ultrasonography,so ultrasonography has an important differential diagnostic value for cervical squamous cell carcinoma and adenocarcinoma.

关 键 词：宫颈鳞癌 宫颈腺癌 超声检查 鉴别诊断 

分 类 号：R737.33[医药卫生—肿瘤]