超声弹性成像技术鉴别诊断子宫肌瘤、腺肌瘤应用价值

The application value of ultrasonic elastosonography for differential diagnosis of hysteromyoma and adenomyoma

目的比较常规超声和点定量弹性成像技术鉴别诊断子宫肌瘤与腺肌瘤的敏感度、特异度、准确度、阳性预测值和阴性预测值,寻求点定量弹性成像技术区分二者的量化标准。方法使用常规超声和点定量弹性成像技术对121例子宫局灶性占位患者和98例正常体检女性进行检查。结合病理,对2种诊断方法进行评价,求出点定量弹性成像技术鉴别肌瘤与腺肌瘤的截断值。结果点定量弹性成像技术较常规超声,敏感度略低,但是特异度、准确度和阳性预测值均高于常规超声检查。与正常组比较,肌瘤的ElastPQ值明显升高,腺肌瘤明显降低,差异有统计学意义(P<0.05)。点定量弹性成像技术鉴别诊断肌瘤、腺肌瘤最佳截断值为14.03kPa。结论点定量弹性成像技术可以提供组织硬度的量化指标,有助于子宫肌瘤和腺肌瘤的鉴别诊断。

Objective To compare the sensitivity, specificity, accuracy rate, positive predictive value, negative of conventional ultrasonography and elasticity point quantification （ElastPQ） technique in the differential diagnosis of hysteromyoma and adenomyoma, and to find out the quantitative criteria. Methods One hundred and twenty-one paitients with mass in uterus and 98 normal people were underwent both conventional ultrasonography and elasticity point quantification technique detection. Two kinds of diagnostic methods were evaluated, and the quantitative elasticity imaging technique was used to identify the cut-off value of hysteromyoma and adenomyoma. Results The sensitivity of ElastPQ was lower than conventional ultrasonography while the specificity, accuracy rate, positive predictive value were higher. Compared with the normal people, ElastPQ value of hysteromyoma were higher while adenomyoma were lower. The ElastPQ value among hysteromyoma, adenomyoma and normal uterus had significant difference（P〈0.05）. The best cutoff value of differentiate hysteromyoma and adenomyoma was 14.03 kPa. Conclusion ElastPQ technique can help differentiate hysteromyoma from adenomyoma by offering quantitative criteria for stiffness of tissue.