经直肠双平面超声在盆腔疾病诊疗中的应用价值  

Application value of double-plane transrectal ultrasonography in diagnosis and treatment of pelvic diseases

作　　者：徐松城 叶瑞忠[1] 贾田爽 王立刚[1] 王珍珍 吕亚儿[1] 李建春[1] 孙立涛 Xu Songcheng;Ye Ruizhong;Jia Tianshuang;Wang Ligang;Wang Zhenzhen;Lyu Ya'er;Li Jianchun;Sun Litao(Cancer Center,Department of Medical Ultrasound,Zhejiang Provincial People's Hospital(Affilicated People's Hospital),Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院(附属人民医院)肿瘤中心超声医学科、杭州医学院,310014

出　　处：《中华医学超声杂志（电子版）》2023年第5期483-486,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金面上项目(82071929)。

摘　　要：目的评价经直肠双平面超声(DPTRUS)在诊治盆腔疾病中的临床价值。方法对2022年8月至2023年3月到浙江省人民医院就诊的盆腔疾病患者进行回顾性分析,所有患者于超声医学科运用经直肠双平面探头(凸阵+线阵)进行常规超声检查、超声造影检查,并行高频超声引导下穿刺活检或置管引流治疗。纳入对象包括173例前列腺疾病、4例直肠旁肿物及1例宫颈癌的超声诊断及穿刺活检;1例子宫直肠窝包裹性积液及1例前列腺脓肿的超声诊断及穿刺置管引流。以病理结果或CT增强检查结果为金标准,统计DPTRUS中常规超声、超声造影诊断前列腺癌的准确性、敏感度和特异度,并采用配对χ^(2)检验判断两者诊断前列腺癌的差异性;统计DPTRUS诊断其他盆腔疾病的准确性。结果DPTRUS中常规超声、超声造影诊断前列腺癌的准确性、敏感度及特异度分别为79.2%、66.3%、93.8%和75.0%、54.1%、95.8%,2种检查诊断前列腺癌的差异无统计学意义(χ^(2)=3.20,P=0.063)。其他盆腔疾病超声诊断准确性均为100%,且所有病例均经会阴成功进行超声介入操作。结论DPTRUS能够对盆腔疾病进行检查,做出准确诊断,还能在高频超声引导下行病灶穿刺活检及穿刺引流治疗等介入性操作,达到诊治一体化的效果。Objective To assess the clinical value of double-plane transrectal ultrasonography(DPTRUS)in the diagnosis and treatment of pelvic diseases.Methods A retrospective analysis was performed on patients with pelvic diseases treated at Zhejiang Provincial People's Hospital from August 2022 to March 2023.The pelvic diseases were diagnosed by routine ultrasound(RUS),contrast-enhanced ultrasound(CEUS),and high-frequency ultrasound guided puncture biopsy or catheter drainage using a bi-planar transrectal probe(convex and linear array),including ultrasonic diagnosis and puncture biopsy of 173 cases of prostate disease,4 cases of pararectal mass,and 1 case of cervical cancer,and ultrasonic diagnosis and catheter drainage of 1 case of encapsulated effusion in the uterine rectal fossa and 1 case of prostatic abscess.The accuracy,sensitivity,and specificity of RUS and CEUS in DPTRUS for the diagnosis of prostate cancer and other pelvic diseases were calculated using pathological examination results or CT enhancement results as gold standard,and the paired chi-square test was used to determine the difference between RUS and CEUS in the diagnosis of prostate cancer.Results The accuracy,sensitivity,and specificity of RUS and CEUS in DPTRUS in the diagnosis of prostate cancer were 79.2%,66.3%,and 93.8%,and 75.0%,54.1%,and 95.8%,and there was no significant difference between them(χ^(2)=3.20,P=0.063).The accuracy of ultrasonic diagnosis for other pelvic diseases was 100%,and all cases successfully underwent perineal ultrasound intervention.Conclusion DPTRUS can correctly diagnose pelvic diseases and perform puncture biopsy for pathological diagnosis and puncture drainage treatment under the guidance of high-frequency ultrasound,thus achieving simultaneous diagnosis and treatment.

关 键 词：经直肠双平面超声 盆腔疾病 诊断 介入 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711[医药卫生—诊断学]