直肠超声双重造影与穿刺活检一体化检查在直肠癌术前病理分型及临床分期中的应用  

Application of combined double contrast-enhanced ultrasonography combined with puncture biopsy in preoperative pathological classification and clinical staging of rectal cancer

作　　者：李金晶 陆文明[1] 茹翱[1] 郭碧萍 姚晓菲 LI Jinjing;LU Wenming;RU Ao;GUO Biping;YAO Xiaofei(Department of Ultrasound,The First People's Hospital of Huzhou,Huzhou 313300,China)

机构地区：[1]浙江省湖州市第一人民医院超声科,浙江湖州313300

出　　处：《医学影像学杂志》2025年第2期92-95,共4页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2019PY015)。

摘　　要：目的探讨直肠超声双重造影(DCEU)与穿刺活检一体化检查在直肠癌术前病理分型及临床分期中的应用。方法选取147例直肠癌患者为观察对象,术前均行直肠灌注超声造影检查、DCEU与穿刺活检一体化检查,以术后病理结果为“金标准”,比较两种方法对直肠癌病理分型、临床分期的诊断效能。结果DCEU与穿刺活检一体化检查诊断直肠癌病理分型的总准确率为87.07%(128/147),直肠灌注超声造影检查为74.83%(110/147),DCEU与穿刺活检一体化检查较直肠灌注超声造影检查总准确率明显高,差异有统计学意义(P<0.05);DCEU与穿刺活检一体化检查诊断直肠癌T分期的总准确率为88.44%(130/147),与术后病理结果一致性良好(Kappa=0.825),直肠灌注超声造影检查诊断直肠癌T分期的总准确率为76.87%(113/147),与术后病理结果一致性一般(Kappa=0.689),DCEU与穿刺活检一体化诊断直肠癌T分期总准确率明显较直肠灌注超声造影检查高,差异有统计学意义(P<0.05);DCEU与穿刺活检一体化检查诊断直肠癌N分期的总准确率为85.03%(125/147),与术后病理结果一致性良好(Kappa=0.771),直肠灌注超声造影检查诊断直肠癌N分期的总准确率为70.75%(104/147),与术后病理结果一致性一般(Kappa=0.562),DCEU与穿刺活检一体化诊断直肠癌N分期总准确率明显较直肠灌注超声造影检查高,差异有统计学意义(P<0.05)。结论DCEU与穿刺活检一体化检查应用于直肠癌术前病理分型及临床分期中可提高准确率,为临床治疗方案制订提供重要参考依据。Objective To investigate the application of double contrast-enhanced ultrasonography(DCEU)combined with puncture biopsy in preoperative pathological classification and clinical staging of rectal cancer.Methods A total of 147 of patients with rectal cancer admitted to our hospital were selected as the research objects,rectal perfusion contrast-enhanced ultrasound examination,DCEU combined with puncture biopsy were performed.The results of postoperative pathological biopsy were taken as the"gold standard"to compare the diagnostic efficacy of the two methods on the pathological classification and clinical staging of rectal cancer.Results The total accuracy of DCEU combined with puncture biopsy in the diagnosis of pathological classification of rectal cancer was 87.07%(128/147),and that of rectal perfusion contrast-enhanced ultrasound examination was 74.83%(110/147),the total accuracy of DCEU combined with puncture biopsy was significantly higher than that of rectal perfusion contrast-enhanced ultrasound examination(P<0.05).The total accuracy of the integrated examination of DCEU combined with puncture biopsy in the diagnosis of rectal cancer T stage was 88.44%(130/147),which was in good agreement with the results of postoperative pathological biopsy(Kappa=0.825),the total accuracy of rectal perfusion contrast-enhanced ultrasound examination in the diagnosis of T stage of rectal cancer was 76.87%(113/147),which was generally consistent with the results of postoperative pathological biopsy(Kappa=0.689),the total accuracy of DCEU combined with puncture biopsy in the diagnosis of T stage of rectal cancer was significantly higher than that of rectal perfusion contrast-enhanced ultrasound(P<0.05).The total accuracy of DCEU combined with puncture biopsy in the diagnosis of N stage of rectal cancer was 85.03%(125/147),which was in good agreement with the results of postoperative pathological biopsy(Kappa=0.771),the total accuracy of rectal perfusion contrast-enhanced ultrasound examination in the diagnosis of N stage of rec

关 键 词：穿刺活检 直肠癌 病理分型 临床分期 直肠超声双重造影 

分 类 号：R735.3[医药卫生—肿瘤] R445[医药卫生—临床医学]