经阴道超声主客观联合法评价早期子宫内膜样癌肌层浸润深度的诊断价值  

The Value of Subjective and Objective Combination Methods of Transvaginal Ultrasound in Myometrial Invasive Depth Assessment of Early Endometrioid Carcinoma

作　　者：杨梦楚 秦艳[2] 刘宇航[3] 潘缘蕊 王璐 林金凤 吕发金[3] Yang Mengchu;Qin Yan;Liu Yuhang;Pan Yuanrui;Wang Lu;Lin Jinfeng;Lv Fajin(State Key Laboratory of Ultrasund in Medicine and Engineering,College of Biomedical Engineering,Chongqing Medical University,Chongqing 400016,China;Department of Gynecology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Radiology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学生物医学工程学院、超声医学工程国家重点实验室,重庆市400016 [2]重庆医科大学附属第一医院妇科,重庆市400016 [3]重庆医科大学附属第一医院放射科,重庆市400016

出　　处：《中国超声医学杂志》2024年第4期448-451,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探索提高经阴道超声(TVS)评估早期子宫内膜样癌肌层浸润深度准确度的方法。方法回顾性分析149例早期子宫内膜样癌的患者。以病理为金标准,采用TVS客观法、主观法及两者联合和磁共振成像(MRI)评估子宫肌层浸润深度,并进行组间、组内一致性分析。通过受试者工作特征(ROC)曲线及Z检验分析和比较4种方法的诊断效能。结果TVS主客观联合法、TVS主观法、TVS客观法、MRI检测子宫肌层浸润的ROC曲线下面积分别为0.845、0.780、0.818、0.889。TVS主客观联合法的诊断效能优于单独诊断且与TVS主观法之间的差异有统计学意义(P<0.05),与MRI之间的差异没有统计学意义(P>0.05)。TVS客观法的组间及组内观察者间一致性(ICC)值分别为0.953和0.938,TVS主观法的组间及组内Kappa值分别为0.947和0.787。结论评估子宫内膜样癌肌层浸润深度时,TVS主客观联合法具有良好的诊断效能,在不具备MRI检查的条件下,可为临床医师选择手术方式提供依据。Objective To improve the diagnostic efficiency of transvaginal ultrasound(TVS)in assessing the depth of myometrial invasion in early endometrioid carcinoma.Methods 149 patients with early-stage endometrioid carcinoma were retrospectively analyzed.With the histopathology as the gold standard,the depth of myometrial invasion was assessed by TVS objective method,subjective method,combination method and magnetic resonance imaging(MRI),and the intergroup and intragroup concordance analyses were performed.The diagnostic efficacy of the 4 methods was analyzed and compared by reseiver operating characteristic(ROC)curves and Z-tests.Results The areas under the ROC curve for myometrial invasion detected by the TVS subjective-objective combined method,TVS subjective method,TVS objective method,and MRI were 0.845,0.780,0.818,and 0.889,respectively.The diagnostic efficacy of the TVS subjective-objective combined method was better than these two method alone.There was a statistically significant difference between the TVS subjective-objective combined method and subjective method(P<0.05),but no statistically significant difference among the objective method and the MRI(P>0.05).The inter-and intra-group intraclass correlation coefficient(ICC)values for the TVS objective method were 0.953 and 0.938,respectively,and the inter-and intra-group Kappa values for the TVS subjective method were 0.947 and 0.787,respectively.Conclusions In the depth of myometrial invasion of endometrial carcinoma evaluation,the TVS subjective-objective combined method has good diagnostic efficacy,and could providing an evidence for choosing the surgical way for clinician when MRI examination is unavailable.

关 键 词：子宫内膜样癌 超声 磁共振 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]