超声造影与阴道彩超对Ⅰ期子宫内膜癌的诊断效果对比研究

Comparative Study of the Effect of Application of Contrast Enhanced Ultrasound and Transvaginal Color Doppler Sonography in Diagnosis of Stage Ⅰ Endometrial Carcinoma

目的探讨超声造影(CEUS)和阴道彩超(TVCDS)对Ⅰ期子宫内膜癌的肌层浸润深度及血流信号的诊断效果的差别。方法选取80例Ⅰ期子宫内膜癌患者,术前均行CEUS和TVCDS检查,术后经病理检查证实为Ⅰ期子宫内膜癌,比较两种检查方法的一致性Kappa值、诊断符合率及血流信号分级。结果 CEUS诊断Ⅰ期子宫内膜癌浸润深度与病理检查的一致性检验Kappa值为0.734,明显高于TVCDS的Kappa值0.515(P<0.05);CEUS的诊断符合率为83.8%,也明显高于TVCDS的70.0%(P<0.05);CEUS检查的血流分级为Ⅱ级占81.3%,明显高于TVCDS的32.5%(P<0.01)。结论 CEUS诊断Ⅰ期子宫内膜癌的一致性及诊断符合率均明显好于TVCDS,而且CEUS检查Ⅰ期子宫内膜癌的血流信号明显强于TVCDS。因此CEUS对早诊断、早治疗子宫内膜癌具有较好的应用价值。

Objective To explore the difference of effects of application between contrast enhanced ultrasound（CEUS） and transvaginal color Doppler sonography（TVCDS） in diagnosis of the depth of muscular layer invasion and blood flow signal of stage Ⅰ endometrial carcinoma. Methods Altogether 80 cases of stage Ⅰ endometrial carcinoma patients were selected, examined by CEUS and TVCDS preoperatively, and post-operatively confirmed as stage Ⅰ endometrial carcinoma through pathological examinations. The Kappa coefficient of agreement, diagnose accordance rate and blood flow signal classification were compared between the two examination methods. Results The Kappa coefficient of agreement between application of CEUS and pathologic examinations in diagnosis of the depth of invasion was 0.734, obviously higher than that between application of TVCDS and pathologic examinations（0.515, P0.05）. The diagnose accordance rate of CEUS was 83.8%, much higher than that of TVCDS（70.0%, P〈0.05）. The blood flow signal classified by using CEUS as Stage Ⅱ endometrial carcinoma took up 81.3%, much higher than TVCDS（32.5%, P〈0.01）. Conclusion The Kappa coefficient of agreement and diagnose accordance rate of CEUS were much better than TVCDS in diagnosis of stage Ⅰ endometrial carcinoma, and CEUS showed much stronger blood flow signal. Therefore, CEUS was of great effectiveness in early diagnosis and treatment of endometrial carcinoma.