对比经阴道三维能量多普勒超声与超声弹性成像在早期宫颈癌临床诊断中的应用价值

摘要

目的 探讨经阴道三维能量多普勒超声以及超声弹性成像技术在早期宫颈癌临床诊断中的应用价值,并比较两种检查方法的优越性.方法 回顾性分析2014年6月~2016年6月于我院接受宫颈超声检查的患者65例作为观察对象,其中病理活检、术后病理证实为早期宫颈癌共40例(宫颈癌组),证实为宫颈上皮内瘤(Cervical Intraepithelial Neoplasia,CIN)样病变共25例(CIN组),另选取体检健康人员20例作为对照组.对所有研究对象进行三维能量多普勒超声、超声弹性成像检查,观察不同分组患者病灶及周围声像图表现.结果 宫颈癌组患者三维能量多普勒血管形成指数(Vascularization Index,VI)(0.27±0.15)、血流指数(Flow Index,FI)(18.6±4.2)、血管形成-血流指数(Vascular Flow Index,VFI)(5.63±3.12)指标明显高于CIN组,VI(0.15±0.08)、FI(14.1±3.7)、VFI(2.80±1.13)、对照组VI(0.07±0.02)、FI(10.82±2.79)、VFI(1.56±0.73)(P<0.05),并且宫颈癌组弹性成像评分高于CIN组与对照组(P<0.05),CIN组弹性评分明显高于对照组(P<0.05),但CIN组VI、FI、VFI与正常对照组比较无显著差异(P>0.05);准确度由高到低为弹性成像、三维能量多普勒、二维超声(84.7>83.0>64.7),敏感度由高到低为三维能量多普勒、弹性成像、二维超声(82.8>82.5>55.6),特异度由高到低为弹性超声、三维能量多普勒、二维超声(86.7>83.4>75.0).结论 经阴道超声弹性成像与三维能量多普勒超声均可有效检出、诊断早期宫颈癌,但二者为临床诊断与治疗提供的参考信息侧重点不同,通过联合应用可提升早期宫颈癌的检出率,提高超声检查对临床治疗的指导价值.%Objective The aim of this paper was to investigate the application value of transvaginal three-dimensional Doppler ultrasound and ultrasonic elastography in the clinical diagnosis of early cervical cancer and to compare the superiority of the two methods. Methods Retrospective analysis 65 patients had taken cervical ultrasound examination as the observation object in our hospital from June 2010 to June 2016, included pathological biopsy, postoperative pathology confirmed early cervical cancer in 40 cases (cervical cancer group), confirmed to be 25 cases of cervical intraepithelial neoplasia (CIN), and 20 cases of healthy people were selected as the control group. All subjects were examined by three-dimensional Doppler ultrasound and ultrasonography. The sonographic features of the lesions were observed in different groups. Results The three-dimensional energy Doppler vascularization index (VI) (0.27±0.15), flow index (FI) (18.6±4.2), vascular flow index (VFI) (2.80±1.13), control group VI (0.07±0.02), FI (10.82±2.79), the control group VI (0.07±0.02), the control group VI (0.07±0.02) (P<0.05), and the elasticity score of CIN group was significantly higher than that of CIN group and control group (P<0.05). The elasticity score of CIN group was significantly higher than that of control group (P<0.05). The accuracy of high accuracy was higher than that of normal control group (P>0.05). The accuracy of high accuracy was higher than that of normal control group (P<0.05) (86.8>82.5>55.6), the specificity from high to low for elastic ultrasound, three-dimensional energy Doppler, two-dimensional ultrasound (86.7>83.4>75.0). Conclusion Transvaginal ultrasound elastography and three-dimensional energy Doppler ultrasound can be effectively detected, the diagnosis of early cervical cancer, but for the clinical diagnosis and treatment of the reference information to provide different emphases, through the combination of early detection of cervical cancer can improve the rate, and improve the value of ultrasound guidance for clinical treatment.