超声造影在子宫滋养细胞病变的鉴别诊断价值

Application of contrast-enhanced ultrasound in the diagnosis of uterine gestational trophoblast lesions

目的探讨超声造影在子宫滋养细胞病变中的应用价值。方法选取2014年1月~2016年4月在我院就诊的滋养细胞病变患者82例,进行超声造影观察。结果 82例患者经病理检查,其中恶性病变32例,良性病变50例;超声造影诊断恶性病变的灵敏度、特异度、阳性预测值和阴性预测值分别为75.00%、80.00%、70.59%和83.33%,与病理检查一致性Kappa值为0.544;良恶性病变增强模式比较差异有统计学意义(P<0.05),恶性病变弥漫型增强模式比例为71.88%,明显高于良性病变;侵蚀性葡萄胎与绒毛膜癌增强模式比较差异有统计学意义(P<0.05);良恶性病变时间-强度曲线各参数比较差异无统计学意义(P>0.05)。结论超声造影在子宫滋养细胞病变诊断中有一定的应用价值,良恶性病变在造影增强模式上有一定差异。

Objective To investigate the value of contrast-enhanced ultrasound in the diagnosis of uterine gestational tropho- blast lesions. Methods From January 2014 to April 2016, 82 cases of gestational trophoblast lesions were seteeted in our hospi- tal, and underwent contrast-enhanced ultrasound. Results 82 cases were examined by pathological examination, including 32 cases of malignant lesions and 50 cases of benign lesions ; The sensitivity, specificity, positive predictive value and negative pre- dictive value of contrast-enhanced ultrasound in diagnosis of malignant lesions were 75% , 80% , 70.59%, 83.33% and, respec- tively, and was consistent with pathologic examination, Kappa value was 0. 544 ; Enhancement pattern of benign and malignant le- sionsdifference was statistically significant （ P 〈 0.05 ）, the proportion of diffuse enhancement pattern of malignant lesions was 71.88%, which was significantly higher than that of benign lesions;Invasive hydatidiform mole and choriocarcinoma enhancement pattern difference was statistically significant （ P 〈 0.05 ） ; There was no significant difference in the parameters of time intensity curve between benign and malignant lesions （ P 〉 0.05）. Conclusion Contrast enhanced ultrasound in the diagnosis of uterine trophoblast lesions has a certain value and there is a certain difference in enhancement pattern of benign and malignant lesions.