侵蚀性葡萄胎与绒毛膜癌应用超声造影的鉴别诊断效能评估  

Performance of contrast-enhanced ultrasound in the differential diagnosis of invasive mole and choriocarcinoma

作　　者：吴招兰 陈雪梅 卢咏梅 WU Zhaolan;CHEN Xuemei;LU Yongmei(Department of Ultrasound,Ji'an Hospital,Shanghai Oriental Hospital,Ji'an,Jiangxi,343000,China)

机构地区：[1]上海市东方医院吉安医院超声科,江西吉安343000

出　　处：《当代医学》2024年第2期133-136,共4页Contemporary Medicine

摘　　要：目的探讨侵蚀性葡萄胎与绒毛膜癌应用超声造影的鉴别诊断效能。方法回顾性分析2019年2月至2021年12月上海市东方医院吉安医院收治的117例恶性滋养细胞患者的临床资料。所有患者均行超声造影检查。以病理检查结果为金标准,分析超声造影对侵蚀性葡萄胎、绒毛膜癌诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值;评估超声造影与病理结果的一致性。分别比较侵蚀性葡萄胎与绒毛膜癌的动态增强时间及超声造影特征。结果超声造影对侵蚀性葡萄胎与绒毛膜癌的灵敏度分别为92.45%、92.00%,特异度分别为98.44%、97.01%,准确度分别为95.73%、94.87%,阳性预测值分别为98.00%、95.83%,阴性预测值分别为94.03%、94.20%;超声造影与病理检查均具有一致性(Kappa=0.912、0.895,P<0.05)。侵蚀性葡萄胎与绒毛膜癌患者绒始增时间、增强时间、达峰时间比较差异无统计学意义。侵蚀性葡萄胎患者边界清晰、弥漫型增强、无增强区域<1/3的占比均高于绒毛膜癌患者,差异有统计学意义(P<0.05);绒毛膜癌患者边界不清晰、环状型增强、无增强区域>2/3的占比均高于侵蚀性葡萄胎患者,差异有统计学意义(P<0.05);侵蚀性葡萄胎与绒毛膜癌患者增强顺序、网状型增强、区域型增强、无增强区域为1/3~1/2、无增强区域为1/2~2/3占比比较差异无统计学意义。结论超声造影对侵蚀性葡萄胎与绒毛膜癌的诊断效能较好,有利于鉴别侵蚀性葡萄胎、绒毛膜癌,可在临床推广应用。Objective To investigate the performance of contrast-enhanced ultrasound in the differential diagnosis of invasive mole and choriocarcinoma.Methods The clinical data of 117 patients with malignant trophoblastic cells treated in Ji'an Hospital,Shanghai Oriental Hospital from February 2019 to December 2021 were retrospectively analyzed.All patients underwent contrast-enhanced ultrasonography.Pathological results were taken as the golden standard,analyze the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of contrast-enhanced ultrasound in the diagnosis of invasive mole and choriocarcinoma.The consistency between contrast-enhanced ultrasound and pathological results was evaluated,the dynamic enhancement time and contrast-enhanced ultrasound characteristics of invasive mole and choriocarcinoma were compared.Results The sensitivity,specificity,accuracy rates,positive predictive values and negative predictive values of contrast-enhanced ultrasound in the diagnosis of invasive mole and choriocarcinoma were 92.45% and 92.00%,98.44% and 97.01%,95.73%and 94.87%,98.00% and 95.83%,94.03% and 94.20%,respectively.Contrast-enhanced ultrasound was consistent with pathological examinations(Kappa=0.912,0.895,P<0.05).There were no significant differences in the time of initial increase,enhancement time and peak time between invasive hydatidiform mole and choriocarcinoma.The proportion of patients with invasive hydatidiform mole with clear boundary,diffuse enhancement and no enhancement area<1/3 was higher than that of patients with choriocarcinoma,and the differences were statistically significant(P<0.05).The proportion of patients with choriocarcinoma with unclear boundary,annular enhancement and no enhancement area>2/3 were higher than those of patients with invasive hydatidiform mole,and the differences were statistically significant(P<0.05).There were no significant differences in the proportion of enhancement sequence,reticular enhancement,regional enhancement,non-enhancement area of 1/

关 键 词：侵蚀性葡萄胎 绒毛膜癌 超声造影 效能评估 鉴别诊断 

分 类 号：R737.33[医药卫生—肿瘤]