摘要
目的研究实时超声弹性成像对宫颈良恶性占位性病变的诊断效能。方法回顾性分析我院2016年1月—2018年3月收治的经手术病理证实的120例宫颈病变患者常规彩色多普勒超声及实时超声弹性成像影像资料,研究不同方法对宫颈良恶性占位性病变的诊断效能。结果宫颈良性占位性病变应变率比值(2.67±1.83)显著低于宫颈恶性占位性病变应变率比值(6.77±2.14),差异有统计学意义(t=11.062,P﹤0.001);以手术病理为诊断"金标准",实时超声弹性成像诊断宫颈良恶性占位性病变的灵敏度为83.82%、特异度为88.46%、准确率为85.83%、阳性预测值为90.47%、阴性预测值为80.70%,kappa值=0.715;常规彩色多普勒超声诊断宫颈良恶性占位性病变的灵敏度为80.88%、特异度为78.84%、准确率为80.00%、阳性预测值为83.33%、阴性预测值为75.93%,kappa值=0.594;联合诊断宫颈良恶性占位性病变的灵敏度为95.58%、特异度为90.38%、准确率为93.33%、阳性预测值为92.85%、阴性预测值为94.00%,kappa值=0.863。受试者工作特征曲线结果显示,实时超声弹性成像、常规彩色多普勒超声及联合诊断宫颈良恶性占位性病变的曲线下面积分别为0.837、0.852、0.914,提示联合诊断效能较高。结论常规彩色多普勒超声及实时超声弹性成像对宫颈良恶性占位性病变均有一定的诊断效能,但联合应用或能取得更大的诊断获益。
Objective To study the diagnostic efficiency of real-time elastosonography in the diagnosis of benign and malignant cervical space-occupying lesions (SOL). Methods The image data of conventional color Doppler ultrasound and real-time elastosonography from 120 patients with surgically and pathologically confirmed cervical lesions who were admitted to our hospital during the period from January 2016 to March 2018 were analyzed retrospectively. The diagnostic efficiency of different methods for benign and malignant cervical SOL was studied. Results The strain ratio (SR) of benign cervical SOL was significantly lower than that of malignant SOL [(2.67±1.83) vs (6.77±2.14)]( t =11.062, P <0.001). With surgical pathology as the golden standard, the sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value and kappa value of SR in differential diagnosis of benign and malignant cervical SOL were 83.82%, 88.46%, 85.83%, 90.47%, 80.70% and 0.715, respectively, while those of conventional color Doppler ultrasound were 80.88%, 78.84%, 80.00%, 83.33%, 75.93% and 0.594 respectively. The sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value and kappa value of combined diagnosis of the two methods were 95.58%, 90.38%, 93.33%, 92.85%, 94.00% and 0.863, respectively. The receiver operating characteristic (ROC) curve showed that the areas under the curves (AUC) of conventional color Doppler ultrasound, real-time elastosonography and combined diagnosis for benign and malignant cervical SOL were 0.837, 0.852 and 0.914, respectively, indicating that the efficiency of combined diagnosis was relatively higher. Conclusion Conclusion Both conventional color Doppler ultrasound and real-time elastosonography can be used to diagnose benign and malignant cervical SOL. However, the efficiency of combined diagnosis is higher.
作者
韩立明
张驰
阿衣尔红
周文秀
HAN Li-ming;ZHANG Chi;A Yierhong;ZHOU Wen-xiu(Department of Ultrasound, Pidu District People's Hospital of Chengdu, Chengdu 611730, China)
出处
《临床误诊误治》
2019年第4期48-51,共4页
Clinical Misdiagnosis & Mistherapy
基金
四川省卫生厅科研课题(130221)
关键词
弹性成像技术
宫颈疾病
宫颈肿瘤
诊断技术和方法
Elastosonography
Cervical diseases
Cervical neoplasms
Diagnostic techniques and methods
