双平面经直肠腔内超声与剪切波弹性成像对中下段直肠癌术前T分期的诊断价值  

Biplane transrectal ultrasound and shear wave elastography in evaluating preoperative T staging of mid-low rectal cancer

作　　者：闫骥 孙宇 张晨雪 李晓宇 王立坤[2] YAN Ji;SUN Yu;ZHANG Chenxue;LI Xiaoyu;WANG Likun(Department of Ultrasound,Zhangjiakou First Hospital,Hebei Zhangjiakou 075000,China;Department of Ultrasound Medicine,the First Affiliated Hospital of Hebei North University,Hebei Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院超声科,河北张家口075000 [2]河北北方学院附属第一医院超声科,河北张家口075000

出　　处：《现代肿瘤医学》2025年第6期982-987,共6页Journal of Modern Oncology

基　　金：河北省医学科学研究课题计划(编号:20220028)。

摘　　要：目的:探讨双平面经直肠腔内超声(transrectal ultrasound,TRUS)和剪切波弹性成像(shear-wave elastography,SWE)对中下段直肠癌术前T分期的诊断价值。方法:纳入94例于张家口市第一医院和河北北方学院附属第一医院就诊的直肠癌患者,术前患者均接受TRUS、SWE、TRUS联合SWE T分期诊断,分析比较上述诊断方法术前分期的准确性及诊断价值。结果:单一诊断模式的诊断准确率分别为81.9%(TRUS)和89.4%(SWE)(P=0.421),二者联合模式的诊断准确率为95.7%,高于单一诊断模式(P<0.05);随着肿瘤T分期的增加,肿瘤组织弹性模量值E_(mean)增加,差异有统计学意义(P<0.05),受试者工作特征曲线显示T_(1)/T_(2)、T_(2)/T_(3)和T_(3)/T_(4)分期最佳诊断截值分别为66.3、90.2和164.5 kPa;TRUS联合SWE能够提高不同T分期的诊断效能。结论:TRUS联合SWE能够显著提高直肠癌T分期准确率,有助于指导临床确定治疗方案。Objective:To evaluate the diagnostic values of biplane transrectal ultrasound(TRUS)and shear-wave elastography(SWE)in evaluating preoperative T staging of mid-low rectal cancer.Methods:94 patients with middle and lower rectal cancer undergoing treatment in Zhangjiakou First Hospital and the First Affiliated Hospital of Hebei North University.All patients received TRUS,SWE,TRUS combined with SWE T staging before surgery.The accuracy and diagnostic value of the above diagnostic methods were analyzed and compared.Results:The diagnostic accuracy of single mode was 81.9%(TRUS)and 89.4%(SWE)(P=0.421),respectively.The diagnostic accuracy of combined mode was 95.7%,which was higher than that of single mode(P<0.05).As the tumor Tstageincreased,the elastic modulus value E_(mean) of the tumor tissue increased,and the difference is statistically significant(P<0.05).The ROC curves of the subjects shows that the optimal diagnostic cutoff values for T_(1/)T_(2),T_(2)/T_(3),and T_(3)/T_(4)stages were 66.3,90.2,and 164.5 kPa,respectively,and the area under the curve was 0.927,0.842,and 0.822,respectively.The TRUS combined with SWE can improve the diagnostic efficiency of different T stages.Conclusion:TRUS combined with SWE can significantly improve the accuracy of T-staging for rectal cancer,which can help to guide clinical determination of treatment plans.

关 键 词：双平面经直肠腔内超声 剪切波弹性成像 中下段直肠癌 T分期 弹性模量 诊断效能 

分 类 号：R735.3[医药卫生—肿瘤]