三维能量多普勒超声成像技术在早期宫颈癌血管检测中的应用

3D power Doppler sonography in the early-stage cervical cancer

目的探讨三维能量多普勒超声定量检测早期宫颈癌肿块内血管的诊断价值及早期宫颈癌肿瘤体积与血管参数(VI、FI、VFI)的相关性。方法对25例临床诊断为早期宫颈癌(Ia～IIa期)的患者(宫颈癌组)及19例宫颈上皮内瘤变(CIN)Ⅱ～Ⅲ级的患者(宫颈上皮内瘤变组)行三维能量多普勒超声检查,测定宫颈或肿块内血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI)3项血管参数,同时观察宫颈癌组患者肿瘤体积与血管参数的相关性,并与20例正常女性(对照组)宫颈的3项血管参数检测值进行比较。结果早期宫颈癌组[VI(5.44±4.02)%、FI(41.61±3.51)及VFI(2.31±1.65)]3项血管参数平均测值明显高于宫颈上皮内瘤变组[VI(1.84±0.62)%、FI(39.17±4.12)、VFI(1.34±0.55)]和对照组[VI(0.77±0.11)%、FI(38.49±3.55)及VFI(0.47±0.33)],差异有统计学意义(P<0.05);宫颈上皮内瘤变组2项血管参数测值VI、VFI亦高于对照组,差异有统计学意义(P<0.05)。早期宫颈癌组患者宫颈肿瘤体积越大,宫颈肿瘤内FI测值也升高,宫颈肿瘤体积与FI测值间存在线性正相关关系,相关系数r=0.523(P=0.007)。结论三维能量多普勒超声是定量检测早期宫颈癌肿块内血流的新方法,可为早期宫颈癌患者超声检查提供更多诊断信息。

Objective To evaluate the intratumoral vascularization in early-stage cervical cancer by three-dimensional （3D） power Doppler sonography. Methods Twenty-five patients with cervical cancer （cervical cancer group ）, nineteen patients with CIN （ CIN group ） and twenty normal controls （ controls group） were studied by transvaginal 3D power Doppler sonography. The blood flow within the tumor or healthy cervix was measured and expressed as the vaseularization index （VI）, flowindex （FI） and vascular- ization flow index （VFI）. Vascular blood flow indices of cervical cancer were compared with those of CIN and normal controls. The tumor volume of the cervical cancer was determined. The relationship between parameters and cervical tumor volume were analysed. Results Cervical cancer group VI： 5.44± 4.02%, FI： 41.61 ±3.51,VFI： 2.31 ±1.65; CIN group ：VI ：1.84 ±0.62% ,FI： 39.17 ±4. 12,VFI： 1.34 ±0.55; controls group ： VI：0.77 ± 0. 11%, FI ： 38.49 ± 3.55, VFI ： 0. 47 ± 0. 33. Significant differences between means for cervical cancer and normal controls were found for following parameters：VI, FI and VFI. Signifi- cant differences between means for CIN and normal controls were also found for VI and VFI. Cervical tumor volume was positively correlated with FI （ r = O. 523, P = 0.007 ） , but not with VI or VFI. Conclusions 3 D power Doppler sonography provides a useful tool to investigate intratumoral vascularization and volume of cervical cancer.