ABSTRACT:Objective To evaluate the value of transvaginal ultrasound elastography in the dif-ferential diagnosis of benign and malignant cervical space-occupying lesions.Methods Transvagi-nal ultrasound elastography was performed in 95 patients with suspected cervical space-occupying lesions.The results achieved by the improved 5-point scoring system and elastic strain ratios (SRs)determination were compared with the pathological results.The area under the receiver-op-erating characteristic(ROC)curve of SRs method and the optimal cut-off point were evaluated by ROC curve.Results Among the 95 patients,histopathology showed benign lesions in 45 and ma-lignant lesions in 50.There was a significant difference in SRs between patients with benign le-sions(1.87±0.70)and patients with malignant lesions(3.72±0.61)(P <0.05).The results of improved 5-point scoring system showed scores 1-2 in 44 and scores 3-5 in 51.The area under the curve of ROC was 0.982.The maximal value of Youden index was 0.896.The optimal cut-off point was 2.83.SRs≥2.83 was found in 49 patients and SRs<2.83 in 46 patients.The sensitivi-ty,specificity and accuracy were,respectively,94.0%,95.6% and 94.7% for SRs measurement,and 94.0%,91.1% and 92.6% for improved 5-point scoring system.There was no difference in diagnostic value for cervical space-occupying lesions between the two methods(P >0.05).Conclu-sion Transviginal ultrasound elastography is valuable in differential diagnosis of benign and ma-lignant cervical space-occupying lesions.%目的：探讨经阴道超声弹性成像鉴别诊断宫颈占位性病变良恶性的价值。方法对95例拟诊为宫颈占位性病变患者行经阴道超声弹性成像检查，参照改良5分法评分标准进行评分，并对病变部位进行弹性应变率比值（elastic strain ratios，SRs）检测，将2种方法得到的结果与病理结果对照；SRs 法的 ROC 曲线下面积和最佳临界点通过 ROC 曲线评价。结果95例患者中：病理证实为良性病变45例，SRs 为1．87±0．70；恶性病变50例，SRs 为3．72±0．61，二者 SRs 比较差异有统计学意义（P ＜0．05）。改良5分评分法评分1～2分44例，3～5分51例；SRs法 ROC 曲线下面积为0．982，约登指数最大值为0．896，ROC 曲线最佳临界点为2．83，SRs≥2．8349例，SRs＜2．8346例；SRs 法诊断的敏感性、特异性和准确性分别为94．0％、95．6％和94．7％，改良5分法评分诊断的敏感性、特异性和准确性分别为94．0％、91．1％和92．6％，2种方法对宫颈占位性病变的诊断价值比较，差异无统计学意义（P ＞0．05）。结论经阴道超声弹性成像对宫颈占位性病变良恶性有较高的鉴别诊断价值。
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