子宫内膜癌患者经阴道超声造影血流灌注特征及定量参数分析  

作　　者：叶玲红[1] 吕晴 何颖韬[1] 周海萍[1] 颜建飞 陈方红[1] 黄岩花[1] 

机构地区：[1]浙江省丽水市中心医院,323000

出　　处：《浙江临床医学》2023年第2期267-269,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省基础公益研究计划项目(LCF20H180018)。

摘　　要：目的 分析子宫内膜癌患者经阴道超声造影(CEUS)血流灌注特征及定量参数.方法 回顾分析65例病理确诊的子宫内膜癌患者的临床资料,观察CEUS病灶血流灌注特征,比较阴道常规超声及CEUS对病灶肌层浸润诊断准确率、敏感度,特异度、阳性预测值、阴性预测值.分析无肌层浸润、<1/2肌层浸润、≥1/2肌层浸润超声造影定量参数灌注时间的变化始增时间(AT)、达峰时间(TTP)、平均通过时间(MTT).结果 CEUS子宫内膜癌血流灌注特征表现以整体均匀高、等增强占81.5%,以早进早退占75.4%,增强后大小较二维增大,占58.4%.CEUS诊断子宫内膜癌肌层浸润程度准确率90.7%,敏感度92.5%,特异度88%、阳性预测值92.5%、阴性预测值88%,其中准确率、特异度、阳性预测值与常规超声比较差异有统计学意义(P<0.05),与病理结果一致性较好(Kappa=0.859,P<0.05).AT、TTP、MTT在子宫内膜癌肌层浸润与无肌层浸润比较,差异有统计学意义(P<0.05).<1/2肌层浸润与≥1/2肌层浸润AT、TTP、MTT比较,差异无统计学意义(P>0.05).结论 子宫内膜癌经阴道CEUS血流灌注具有特征性,结合定量参数可提高对肌层浸润程度判断,对指导术前评估分期、治疗有较高临床价值.Objective To investigate the perfusion characteristics and quantitative parameters of transvaginal CEUS(CEUS)in patients with endometrial cancer.Methods65 patients with endometrial cancer diagnosed by pathology in our hospital were retrospectively analyzed.The characteristics of blood perfusion of CEUS were observed.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of conventional vaginal ultrasound and CEUS in the diagnosis of focal myometrial invasion were compared.The changes of perfusion time of quantitative parameters of CEUS without myometrial infiltration,<1/2 myometrial infiltration and≥1/2 myometrial infiltration were analyzed.Results The overall uniform high and equal enhancement accounted for 81.5%,early advance and early leave accounted for 75.4%,and the size increased compared with two-dimensional after enhancement accounting for 58.4%.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of contrast-enhanced ultrasonography were 90.7%,92.5%,88%,92.5%and 88%,respectively.The difference of accuracy,specificity and positive predictive value was statistically significant(P<0.05),which was consistent with the pathological results(kappa=0.859,P<0.05).There were significant diferences in AT,TTP and MTT between the groups with and without myometrial infiltration in endometrial carcinoma(P<0.05).There was no significant difference in AT,TTP and MTT between 1/2 and≥1/2 myometrial infiltration groups(P>0.05).Conclusion Transvaginal CEUS perfusion of endometrial cancer has characteristics.Combined with quantitative parameters,it can improve the judgment of the degree of myometrial invasion,and it has high clinical value in guiding preoperative evaluation,staging and treatment.

关 键 词：子宫内膜癌 经阴道超声造影 血流灌注特征 定量参数 

分 类 号：R737.33[医药卫生—肿瘤]