经阴道超声实时弹性成像对宫颈癌诊断的临床价值评价-现代医学

经阴道超声实时弹性成像对宫颈癌诊断的临床价值评价

单位：江苏大学附属昆山医院超声科, 江苏昆山 215300

分类号：R445.1;R737.33

出版年·卷·期（页码）：2018·46·第三期（255-258）

摘要：

目的：分析宫颈癌超声弹性成像（ultrasound elastography，UE）的声像图特征，探讨经阴道超声实时弹性成像技术中弹性评分法、应变率比值法在宫颈癌诊断中的价值。方法：对疑诊宫颈病变的84例女性患者行经阴道超声弹性成像检查，获得弹性评分和应变率比值，以病理诊断结果为金标准，应用ROC曲线来评价弹性评分法、应变率比值法对宫颈癌的诊断效能。结果：超声弹性评分法与应变率比值法诊断宫颈癌受试者工作特征曲线（ROC曲线）下面积分别为0.79、0.809（P<0.05），当超声弹性评分与应变率比值最佳截断值为4和3.22时对宫颈癌诊断的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为64.9%（24/37）、78.7%（37/47）、72.6%（61/84）、70.6%（24/34）、74%（37/50）和70.3%（26/37）、80.9%（38/47）、76.2%（64/84）、74.3%（26/35）、77.6%（38/49）。结论：经阴道实时超声弹性成像中弹性评分法、应变率比值法对宫颈癌均有较好的诊断价值，可作为临床宫颈癌筛查和诊断中的有益弥补；应变率比值法作为半定量诊断方法，其敏感度、特异度、准确度高于弹性评分法。

Objective: To investigate the diagnostic performance of transvaginal ultrasound elastography (TVES) for cervical cancer,including elasticity score and strain ratio method, then explore the diagnose value of TVES.Methods: Totally 84 patients with cervical lesions underwent TVES, elasticity score and strain ratio were obtained before treatment, ROC curves were used to assess the diagnostic performance of TVES. Results: The areas under the ROC curve of elastic score method and strain ratio method were 0.79, 0.809(P<0.05), respectively. Taking 4 as a diagnostic cutoff value of the elastographic score value and 3.22 as a diagnostic cutoff of the strain ratio value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 64.9% (24/37), 78.7% (37/47), 72.6% (61/84), 70.6% (24/34), 74% (37/50) and 70.3%(26/37),80.9%(38/47),76.2%(64/84),74.3%(26/35),77.6%(38/49), respectively.Conclusion: The elastic score method and strain ratio method in TVES have a certain diagnostic value for cervical cancer, TVES can be used as a useful supplement to the screening and diagnosis of cervical cancer. The strain ratio as a semi-quantitative diagnostic method, it's sensitivity, specificity,accuracy are slightly higher than those of the elastic score method.

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