三维超声造影在膀胱肿瘤分期中的应用价值

Application value of three-dimensional contrast-enhanced ultrasound in bladder tumor staging

目的 探讨三维超声造影(3D-CEUS)在膀胱肿瘤分期中的应用价值。方法 回顾性分析54例膀胱肿瘤患者共60个膀胱肿瘤三维超声检查、二维超声造影和3D-CEUS图像资料,重建三维超声造影图像后利用后处理软件观察病灶的边界,并与病理结果进行比较。结果 60个膀胱肿瘤经手术后病理证实表浅型膀胱肿瘤(Ta期)29个,侵犯皮下结缔组织的肿瘤(T1期)11个,浸润性膀胱肿瘤(>T1期)20个(分别为T2a期4个,T2b期6个,>T2期10个)。膀胱肿瘤3D-CEUS术前分期与病理结果的符合率分别为:Ta期72.4%(21/29),T1期90.9%(10/11),>T1期100%(20/20),总符合率为85.0%(51/60)。结论 3D-CEUS可以较准确地判断膀胱肿瘤浸润膀胱壁的深度,可提高膀胱肿瘤术前分期诊断准确率。

Objective To evaluate the effects of three-dimensional contrast-enhanced ultrasound （3D-CEUS） in bladder tumor staging. Methods Sixty bladder tumor lesions from fifty-four patients examined by three-dimensional ultrasound （3D-US）,two-dimensional contrast-enhanced ultrasound （2D-CEUS） and 3D-CEUS were analyzed retrospectively. The lesion boundary was indicated through post-treatment file after 3 D image reconstruction, and compared with the pathologic stages. Results Sixty noninvasive tumors were revealed by pathology ： 29 category Ta, 11 category T1 ; 20 invasive tumors, including 4 category T2a, 6 category T2b, and 10 category 〉 T2. The coincidence rate of 3D-CEUS with pathology in judging superficial tumors（Ta）, Lamina propria infiltrating tumors （ T1 ）, invasive tumors （ 〉 T1 ） were 72. 4% （21/29）, 90.9% （ 10/11 ） and 100% （20/20） , respectively. The overall accuracy was 85.0% （ 51/60）. Conclusion 3D-CEUS can estimate the invasion depth of bladder tumor accurately and improve the diagnostic accuracy of bladder tumor staging before operation.