经阴道超声RTE联合经阴道常规超声诊断宫颈癌的价值-东南大学学报医学版

经阴道超声RTE联合经阴道常规超声诊断宫颈癌的价值

单位：西安市人民医院/西安市第四医院超声医学中心, 陕西西安 710004

分类号：R737.33

出版年·卷·期（页码）：2024·43·第二期（224-228）

摘要：

目的: 探讨经阴道超声实时弹性成像(RTE)联合经阴道常规超声在宫颈癌中的诊断价值。方法: 选取本院2020年5月至2023年5月期间治疗的疑似宫颈癌患者194例作为研究对象,病理结果证实宫颈良性病变患者96例(良性病变组),宫颈癌患者98例(宫颈癌组),所有患者均行经阴道常规超声和经阴道超声RTE检查。结果: 良性病变组和宫颈癌组边界比较,差异无统计学意义(P＞0.05),宫颈癌组弹性硬度评分5分患者比例、肿瘤最大径、低回声患者比例、血流分级Ⅲ级患者比例明显高于良性病变组(P＜0.05)。经阴道常规超声单独及联合经阴道超声RTE诊断宫颈癌与病理组织检查结果的一致性分别为中度、极高,Kappa值分别为0.527、0.814(P＜0.05)。经阴道常规超声单独及联合经阴道超声RTE诊断宫颈癌的ROC曲线下面积(AUC)分别为0.765(95%CI 0.696~0.834)、0.907(95%CI 0.860~0.954)。联合诊断宫颈癌的敏感度、阴性预测值、准确度显著高于经阴道常规超声单独诊断,漏诊率显著低于经阴道常规超声单独诊断(P＜0.05)。结论: 经阴道常规超声联合经阴道超声RTE对于宫颈癌的鉴别诊断具有重要价值,二者联合的结果与病理诊断的一致性较高。

Objective: To explore the diagnosis value of transvaginal conventional vaginal ultrasound combined with transvaginal ultrasound real time elastography(RTE) in the early diagnosis of cervical cancer. Methods: From May 2020 to May 2023, 194 suspected cervical cancer patients treated in our hospital were collected as research subjects. Pathological results confirmed 96 cases of cervical benign lesions(benign lesion group) and 98 cases of cervical cancer(cervical cancer group). All patients underwent transvaginal conventional ultrasound and transvaginal ultrasound RTE. Results: There was no statistically obvious difference in the boundary between the benign lesion group and the cervical cancer group(P>0.05), the proportion of patients with a hardness score of 5, the maximum diameter of the tumor, the proportion of patients with low echogenicity, and the proportion of patients with blood flow grade Ⅲ in the cervical cancer group were significantly higher than those in the benign lesion group(P<0.05). The consistency between transvaginal conventional ultrasound alone and it combined transvaginal ultrasound RTE with pathological tissue examination results was moderate and extremely high respectively, with Kappa value of 0.527 and 0.814 respectively(P<0.05). The area under the ROC curve(AUC) of the diagnosis of transvaginal conventional ultrasound alone and combination with transvaginal ultrasound RTE was 0.765(95%CI 0.696-0.834) and 0.907(95%CI 0.860-0.954), respectively. The sensitivity, negative predictive value, and accuracy of transvaginal conventional ultrasound combined with transvaginal ultrasound RTE in the diagnosis of cervical cancer were obviously higher than those of transvaginal conventional ultrasound alone, and the missed diagnosis rate was obviously lower than that of transvaginal conventional ultrasound alone(P<0.05). Conclusion: The combination of transvaginal conventional ultrasound and transvaginal ultrasound RTE has important value in the differential diagnosis of cervical cancer in clinical practice, and the results of the combination of the two are highly consistent with the final pathological diagnosis.

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