超声造影联合实时剪切波弹性成像技术在阴囊肿块诊断中的应用价值  

Application value of contrast-enhanced ultrasound combined with real-time shear wave elastography in the diagnosis of scrotal masses

作　　者：马腾[1] 刘昕[1] 王艳军[1] 王安军[1] 李昊 刘克[1] Ma Teng;Liu Xin;Wang Yanjun;Wang Anjun;Li Hao;Liu Ke(Department of Ultrasound,Baoding First Central Hospital,BaoDing 071000,HeBei,China)

机构地区：[1]保定市第一中心医院超声一科,河北保定071000

出　　处：《中国男科学杂志》2023年第4期59-66,共8页Chinese Journal of Andrology

基　　金：保定市科技计划项目(编号:1941ZF035)。

摘　　要：目的探讨分析超声造影联合实时剪切波弹性成像技术在阴囊肿块诊断中的应用价值。方法选取我院2019年10月至2021年10月收治的经手术病理确诊的120例阴囊肿块患者,对病灶区进行超声造影、实时剪切波弹性成像(shear waveelastopraphy,SWE),并与术后病理结果进行比较,分析超声造影联合实时剪切波弹性成像技术对阴囊肿块良性、恶性病变的诊断效能。结果120例患者共128个阴囊肿块,病理结果显示恶性病变75例,其中精原细胞瘤45.33%(34/75),混合性生殖细胞肿瘤24.00%(18/75),去分化脂肪肉瘤16.00%(12/75),其他恶性肿瘤14.67%(11/75);良性病变53例个,其中良性病变中炎症26.42%(14/53),结核18.87%(10/53),囊肿28.83%(9/53),睾丸扭转5.66%(7/53),隐睾9.43%(5/53),其他良性病变15.09%(8/53)。常规超声对阴囊肿块良性、恶性病变诊断指标中,内部血流诊断阴囊肿块良性、恶性具有统计学意义(P<0.05),超声造影对阴囊肿块良性、恶性病变诊断指标中,增强强度、增强均匀度、增强方式、消退方式具有统计学意义(P<0.05)。实时剪切波弹性成像技术对阴囊肿块良性、恶性病变诊断指标中,纵切面弹性模量值、横切面弹性模量值、弹性模量值、Eratio具有统计学意义(P<0.05);超声造影和实时剪切波弹性成像,两者联合对阴囊肿块诊断结果的Kappa值为0.967,联合检测与病理结果一致性较好(P<0.05)。联合诊断对阴囊肿块良性、恶性病变灵敏度显著高于单一超声造影(χ^(2)=6.822,P=0.009);高于单一实时剪切波弹性成像技术(χ^(2)=4.807,P=0.028)。ROC曲线结果显示,超声造影诊断阴囊肿块良性、恶性病变的ROC曲线下面积为0.82(95%CI:0.648~0.849),此时灵敏度和特异度分别为85.33%、69.81%;实时剪切波弹性成像技术诊断阴囊肿块良性、恶性病变的ROC曲线下面积为0.85(95%CI:0.692~0.811),灵敏度和特异度分别为88.00%、73.58%;两者联合诊断阴囊肿块良性、�Objective To explore the application value of contrast-enhanced ultrasound combined with real-time shear wave elastography in the diagnosis of scrotal masses.Method A total of 120 patients with scrotal mass diagnosed by surgery and pathology in our hospital from October 2019 to October 2021 were enrolled in the study.Contrast-enhanced ultrasound and real-time shear wave elastography(SwE)were performed on the lesion area.The diagnosis results of benign and malignant lesions of scrotal mass by contrast-enhanced ultrasound and real-time shear wave elastography and postoperative pathological results were comparatively analyzed.The diagnostic efficacy of contrast-enhanced ultrasound combined with real-time shear wave elastography in benign and malignant lesions of scrotal masses was evaluated.Result There were 128 lesions in scrotal mass tissues of 120 patients.Pathological results showed 75 cases had malignant lesions including seminoma(45.33%,34/75),mixed germ cell tumor(24.00%,18/75),dedifferentiated liposarcoma(16.00%,12/75),and other malignant tumors(14.67%,11/75);53 cases had benign lesions,including inflammation(26.42%,14/53),tuberculosis(18.87%,10/53),cysts(28.83%,9/53),testicular torsion(5.66%,7/53),cryptorchidism(9.43%,5/53),and other benign lesions(15.09%,8/53).The internal blood flow of conventional ultrasound in the diagnosis of benign and malignant lesions of scrotal mass was statistically significant(P<0.05).Conventional ultrasound image of malignant lesions showed internal blood flow.Contrast-enhanced ultrasound exhibited statistical significances in enhancement intensity,enhancement uniformity,enhancement mode,and regression mode(P<0.05)between benign and malignant lesions of scrotal mass.the ultrasound features of malignant lesions were mainly characterized by rapid/synchronous uneven high enhancement,rapid and slow regression;the ultrasound features of benign lesions were mainly characterized by homogeneous low-enhancement/no enhancement,synchronous regression.Real-time shear wave elastography exhib

关 键 词：超声造影弹性成像技术 阴囊 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R697.21[医药卫生—诊断学]