超声弹性成像及阴道超声检查在子宫颈占位性病变诊断中的对比研究

Comparative study of real-time elastography and transvaginal ultrasonography in diagnosis of cervical occupied lesions

目的:比较超声弹性成像及阴道超声在子宫颈占位性病变中的应用价值。方法:对65例(109个)子宫颈占位性病灶进行纵横切面弹性扫查,将弹性图像分为1-5级。同时采用阴道超声检查诊断肿块大小、形态、境界、边界、内部回声、有无钙化、后方回声改变等,将超声诊断结果与病理结果作对比。结果:阴道超声诊断子宫颈占位性病灶的灵敏度、特异度和准确度分别为85.71%、82.11%、82.57%;弹性成像横切面分别为100.00%、63.16%、67.89%;弹性图像纵切面分别为100.00%、58.95%、64.22%,与病理学诊断差异均有统计学意义(P<0.01)。将阴道超声和弹性图像进行联合诊断,则横断面弹性图像分别为85.71%、93.68%、92.66%;纵断面弹性图像分别为85.71%、92.63%、91.74%,与病理学诊断差异均无统计学意义(P>0.05)。阴道超声、弹性成像、阴道超声联合弹性成像诊断子宫颈占位性病变的差异均有统计学意义(P<0.01);纵切面与横切面诊断差异无统计学意义(P>0.05)。结论:超声弹性成像能为子宫颈占位性病变的诊断提供一定的信息,但仍需结合阴道超声诊断指标。

Objective：To compare real-time elastography and transvaginal ultrasound in diagnosis of cervical occupied lesions.Methods：Elastography screening was performed on 109 cervical occupied lesions in 65 patients,and the findings were classified into 5 grades;transvaginal ultrasoungraphy was used to detect the tumor size,shape,state,border,internal echo,calcification and the rear echo changes;the results by the two methods were compared.Results：The sensitivity,specificity and accuracy were 85.71%,82.11% and 82.57%,respectively by transvaginal ultrasoungraphy,while they were 100.00%,63.16% and 67.89% in cross section,and 100.00%,58.95% and 64.22% in longitudina section,respectively by elastography.Statistical results showed there was significant difference for elastography and pathological diagnosis（P0.01）.Transvaginal ultrasound in conjunction with real-time elastography in longitudinal section and cross section were 85.71%,93.68%,92.66% and 85.71%,92.63%,91.74%,respectively,statistical results showed there was no significant difference for elastography and pathological diagnosis（P0.05）.The sensitivity,specifity and the accuracy of real-time elastography and transvaginal ultrasound and transvaginal ultrasound in conjunction with real-time elastography for cervical occupide lesions were statistically significant（P0.01）,there was no significant eifference between cross-sectional and longitudinal-sectional（P0.05）.Conclusions：Elastosonography may provide some useful information for diagnosis of cervical occupied lesions,but findings by transvaginal ultrasound are still indispensable for final diagnosis.