超微血流成像与超声造影鉴别诊断早期子宫颈癌及癌前病变的对比研究  

Comparative Study of Superb Microvascular Imaging and Contrast-Enhanced Ultrasound in the Differential Diagnosis of Early-Stage Cervical Cancer and Premalignant Lesions of Uterine Cervix

作　　者：李晏杰 蒋卓霖 张杰[2] 贾世军[3] 唐益馨 罗欣怡 张国楠[2] 朱熠[1] Li Yanjie;Jiang Zhuolin;Zhang Jie;Jia Shijun;Tang Yixin;Luo Xinyi;Zhang Guonan;Zhu Yi(Department of Ultrasound,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Gynecologic Oncology,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Pathology,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Ultrasound,Suining Central Hospital,Suining 629099,Sichuan,China)

机构地区：[1]四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院超声医学中心,成都610041 [2]四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院妇科肿瘤中心,成都610041 [3]四川省肿瘤临床医学研究中心,四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学附属肿瘤医院病理科,成都610041 [4]遂宁市中心医院超声科,四川遂宁629099

出　　处：《肿瘤预防与治疗》2024年第9期767-774,共8页Journal of Cancer Control And Treatment

基　　金：中国博士后科学基金(编号:2023M730510)。

摘　　要：目的:对比研究超微血流显像(superb microvascular imaging,SMI)与超声造影(contrast enhanced ultrasound,CEUS)在鉴别诊断早期子宫颈癌及高级别上皮内病变(high-grade squamous intraepithelial lesion,HSIL)中的价值。方法:利用SMI和CEUS定量分析软件回顾性分析经病理证实的早期子宫颈癌[38例,平均年龄(49.4±10.2)岁]及癌前病变(即HSIL)[24例,平均年龄(48.3±8.6)岁]血管指数(vascular index,VI)和12个CEUS定量参数的差异。比较VI和CEUS定量参数对早期子宫颈癌及HSIL的鉴别诊断效能。结果:与癌前病变组相比,早期子宫颈癌组的VI、峰值强度(peak intensity,PI)、曲线下面积(area under the curve,AUC)、曲线下灌注面积、曲线下廓清面积(washout area under curve,oAUC)、灌注率(wash-in rate,WiR)、平均强度和标准差均升高,差异有统计学意义(均P<0.05)。VI与CEUS定量参数PI(r=0.784,P<0.001)、AUC(r=0.678,P<0.001)、oAUC(r=0.668,P<0.001)、WiR(r=0.671,P<0.001)、平均强度(r=0.635,P<0.001)高度相关。VI的鉴别诊断准确性和敏感性分别为87.4%和97.4%,高于CEUS定量参数,而特异性为62.7%,低于除PI以外的其它CEUS定量参数。结论:SMI在鉴别诊断早期子宫颈癌及癌前病变(HSIL)方面显示出与CEUS相当的效能。Objective:To compare the value of superb microvascular imaging(SMI)and contrast-enhanced ultrasound(CEUS)in the differential diagnosis of early cervical cancer and high-grade squamous intraepithelial lesions(HSIL).Methods:Retrospective analysis was conducted using SMI and CEUS quantitative analysis software on pathologically confirmed cases of early cervical cancer[38 cases,average age:(49.4±10.2)years]and premalignant cervical lesions(HSIL)[24 cases,average age:(48.3±8.6)years].Differences in vascular index(VI)and 12 quantitative CEUS parameters were analyzed.The diagnostic efficacy of VI and quantitative CEUS parameters in differentiating early cervical cancer and HSIL was compared.Results:Compared with premalignant cervical lesion group,early-stage cervical cancer group showed significant increases in VI,peak intensity(PI),area under the curve(AUC),wash-in area under the curve,wash-out area under the curve(oAUC),wash-in rate(WiR),mean intensity and standard deviation(all P<0.05).VI was highly correlated to CEUS quantitative parameters PI(r=0.784,P<0.001),AUC(r=0.678,P<0.001),oAUC(r=0.668,P<0.001),WiR(r=0.671,P<0.001),and mean intensity(r=0.635,P<0.001).The diagnostic accuracy and sensitivity of VI were 87.4%and 97.4%,respectively,higher than those of CEUS quantitative parameters,while the specificity of VI was 62.7%,lower than those of CEUS quantitative parameters except for PI.Conclusion:SMI demonstrated comparable efficacy to CEUS in the differential diagnosis of early-stage cervical cancer and premalignant cervical lesions(HSIL).

关 键 词：子宫颈癌 高级别上皮内病变 超微血流成像 超声造影 血管指数 时间强度曲线 

分 类 号：R737.33[医药卫生—肿瘤] R730.41[医药卫生—临床医学]