摘要
目的应用经阴道实时剪切波弹性成像(SWE)定量分析宫颈良恶性病变。方法选取我院经病理活检结果确诊的49例宫颈癌患者(宫颈癌组)、宫颈上皮内瘤变患者53例(CIN组)、宫颈良性病变患者60例(良性病变组),另选同期健康体检者60例为对照组。应用经阴道SWE检测各组弹性模量绝对数值(包括弹性模量最大值和平均值),并对各组进行比较分析。绘制受试者工作特征(ROC)曲线评估弹性模量绝对数值对宫颈癌的诊断效能。结果对照组不同生理时期及不同切面间宫颈弹性模量平均值、最大值比较差异分别无统计学意义。宫颈癌组弹性模量最大值和平均值均高于CIN组、良性病变组、对照组(Bonferroni校正P<0.017)。弹性模量最大值、弹性模量平均值与宫颈病变程度均呈显著正相关(ρ=0.586、0.713,均P=0.000);弹性模量最大值和平均值诊断宫颈癌的截断值分别为48.08 kPa、36.89 kPa,曲线下面积分别为0.908、0.996,二者比较差异有统计学意义(P<0.05)。结论经阴道SWE检查测得的弹性模量最大值和平均值对宫颈癌均有较好的诊断效能,且二者均与患者月经周期、超声切面选择等因素相互独立,其中弹性模量平均值诊断效能更佳。
Objective To explore the application value of transvaginal real time shear wave elastography(SWE)in the diagnosis of benign and malignant cervical diseases.Methods Forty-nine cervical carcinoma patients diagnosed by pathological results were employed as cervical carcinoma group,53 cervical intraepithelial neoplasia(CIN)patients and 60 benign cervical lesions patients were respectively employed as CIN group and benign group,and 60 healthy women as control group.Maximum elasticity value and mean elasticity value of the four groups were measured by SWE and compare.ROC curve was drawn to assess the efficacy of elasticity modulus in diagnosis of cervical carcinoma.Results In the control group,there was no statistical difference of mean elasticity value and maximum elasticity value respectively in different physiological periods and mode.Maximum elasticity value and mean elasticity value in the cervical carcinoma group were respectively higher than those in the CIN group,benign group and control group(Bonferroni adjust P<0.017).There was significant positive correlation between maximum elasticity value or mean elasticity and the degree of cervical lesions(ρ=0.586,0.713,both P=0.000).Cut-off value of maximum elasticity value and mean elasticity value were 48.08 kPa and 36.89 kPa,area under ROC curve were 0.908 and 0.996,respectively.Conclusion Maximum elasticity value and mean elasticity value obtained by SWE can bring satisfying diagnostic efficiency in diagnosis of cervical cancer and precancerous lesions,both are independent to patients’menstrual cycles and ultrasonic sections.Mean elasticity value can be the significant observed indicator in the diagnosis of benign and malignant cervical diseases.
作者
江玉芳
汪丽秀
JIANG Yufang;WANG Lixiu(Department of Ultrasound,the People’s Hospital of Changxing County,Zhejiang 313100,China)
出处
《临床超声医学杂志》
CSCD
2020年第6期440-443,共4页
Journal of Clinical Ultrasound in Medicine
关键词
剪切波弹性成像
经阴道
实时
宫颈癌
宫颈上皮内瘤变
Shear wave elastography
transvaginal
real time
Cervical carcinoma
Cervical intraepithelial neoplasia
