超声弹性成像及超微血管成像诊断宫颈癌:单一方法与联合诊断对比  

Ultrasonic elastography and superb microvascular imaging for diagnosing cervical cancer:Comparison on single method and their combination

作　　者：杭玉莹 张颖[2] 魏宏[3] 李斌斌 王超[2] 姜阳[2] 杨欣[2] HANG Yuying;ZHANG Ying;WEI Hong;LI Binbin;WANG Chao;JIANG Yang;YANG Xin(School of Medical Imaging,Mudanjiang Medical University,Mudanjiang 157000,China;Department of Ultrasound,Jiamusi Central Hospital,Jiamusi 154000,China;Department of Gynaecology,Jiamusi Central Hospital,Jiamusi 154000,China)

机构地区：[1]牡丹江医学院医学影像学院,黑龙江牡丹江157000 [2]佳木斯市中心医院超声科,黑龙江佳木斯154000 [3]佳木斯市中心医院妇科,黑龙江佳木斯154000

出　　处：《中国医学影像技术》2024年第7期1087-1091,共5页Chinese Journal of Medical Imaging Technology

基　　金：黑龙江省卫生健康委科研课题(20210909020184)。

摘　　要：目的对比观察单一超声剪切波弹性成像(SWE)、超微血管成像(SMI)及其联合常规超声诊断宫颈癌的价值。方法回顾性分析178例经病理确诊宫颈病变患者,包括恶性32例(恶性组)及良性146(良性组),并将后者分为低级别或高级别宫颈上皮内瘤样病变、宫颈肌瘤、宫颈息肉及宫颈炎共5个亚组。分析病变常规超声、SWE和SMI表现,测量平均杨氏模量值(E_(mean))及SMI血流指数(Ratio);绘制受试者工作特征(ROC)曲线,获取其最佳截断值,据以预测宫颈良、恶性病变;以Kappa检验评估预测及诊断结果与病理结果的一致性,并比较单一常规超声、SWE及SMI及其联合诊断宫颈癌的效能。结果恶性组患者年龄大于良性组(P<0.05);恶性组SWE E_(mean)及SMI Ratio高于各良性亚组(P均<0.05)。分别以44.35 kPa、3.95%为最佳截断值,SWE E_(mean)及SMI Ratio预测宫颈良、恶性病变与病理结果的一致性分别为较好(Kappa=0.818)及中等(Kappa=0.453)。单一常规超声、SWE及SMI诊断宫颈癌的效能(AUC=0.845、0.914、0.892)均高于三者联合(AUC=0.806,校正P均<0.05);SWE及SMI诊断宫颈癌的敏感度分别为90.60%及93.78%,特异度分别为95.20%及72.60%。结论SWE诊断宫颈癌效能较高;SMI敏感度佳但特异度偏低。联合应用常规超声、SWE及SMI并不能提高超声诊断宫颈癌效能。Objective To observe the value of shear wave elastography(SWE),superb microvascular imaging(SMI)and their combination with conventional ultrasound for diagnosing cervical cancer.Methods Data of 178 patients with cervical lesion confirmed by pathology were retrospectively analyzed.The patients were divided into malignant group(n=32)and benign group(n=146),and those in benign group were further divided into low-grade or high-grade cervical intraepithelial neoplasia subgroups,cervical leiomyosarcoma subgroup,cervical polyps subgroup and cervicitis subgroup.The manifestations of lesion on conventional ultrasound,SWE and SMI were observed,and the mean value of Young's modulus(E_(mean))and SMI flow index(Ratio)were collected.The optimal cut-off value of SWE E_(mean) and SMI Ratio were obtained with receiver operating characteristic(ROC)curves,and the classification of benign or malignant lesions were predicted.The consistency of predictive results and pathology results were assessed with the Kappa test.The diagnostic efficacies of conventional ultrasound,SWE and SMI alone and their combination were compared.Results The age of patients in malignant group was higher than that in benign group(P<0.05).SWE E_(mean) and SMI Ratio were both higher in malignant group than those in each benign subgroup(all P<0.05).Taken 44.35 kPa and 3.95%as the best cut-off values,the consistency of SWE E_(mean) classification results and pathological results was good(Kappa=0.818),while of SMI Ratio was moderate(Kappa=0.453).The efficacy of conventional ultrasound,SWE and SMI alone for classifying benign and malignant cervical lesions(AUC=0.845,0.914,0.892)were all higher than that of their combination(AUC=0.806,all adjusted P<0.05).The sensitivity of SWE and SMI for diagnosing cervical cancer was 90.60%and 93.78%respectively,with specificity of 95.20%and 72.60%,respectively.Conclusion SWE hag higher efficacy for diagnosing cervical cancer,while SMI had better sensitivity but lower specificity.Combination of conventional ultrasound,SWE and SWI

关 键 词：宫颈疾病 弹性成像技术 超声检查 多普勒 彩色 

分 类 号：R711.74[医药卫生—妇产科学] R445.1[医药卫生—临床医学]