经阴道实时超声弹性成像对正常宫颈、宫颈癌前病变和宫颈癌的诊断价值

The Value of Transvaginal Real-time Ultrasound Imaging in the Diagnosis of Normal Cervix,Cervical Precancerous Lesion and Cervical Cancer

目的研究经阴道实时超声弹性成像对正常宫颈、宫颈癌前病变及宫颈癌的诊断价值。方法选择60例宫颈癌患者为宫颈癌组、60例宫颈上皮内瘤变患者为病变组、50例体检健康、宫颈无病变者为对照组,观察3组研究对象的宫颈常规超声图像特征和超声弹性成像图像特征,并比较3组的宫颈弹性成像硬度评分。结果对照组弹性成像硬度评分82.00%(41/50)为1分,病变组81.67%(41/60)为2~3分,宫颈癌组95.00%(57/60)为3~5分。以弹性成像硬度评分≥3分为截断值以诊断宫颈癌,经阴道实时超声弹性成像诊断宫颈癌的敏感性为95.00%,特异性为92.13%。宫颈癌组、病变组和对照组的弹性成像硬度评分分别为(3.87±0.86)分、(2.05±0.73)分、(1.20±0.59)分,宫颈癌组的评分均明显高于病变组和对照组(P<0.05)。结论正常宫颈、宫颈癌前病变及宫颈癌宫颈组织的弹性成像图像具有特征性表现,经阴道实时超声弹性成像可以作为宫颈癌诊断的有效方法。

Objective To investigate the value of transvaginal real-time ultrasound imaging in the diagnosis of normal cervix, cervical precancerous lesion and cervical cancer. Methods Selected 60 cases of patients with cervical cancer was cervical cancer group,60 cases of cervical intraepithelial neoplasia patients was lesion group,50 cases of healthy persons was the control group. The cervical conventional ultrasound image features and ultrasound imaging features of the 3 groups were observed, and the elastographic scores of cervix were compared. Results 82.00% （41/50） of the control group was 1 points, and 81.67% （41/ 60） of the lesion group was 2 -3 points ,and 95.00% （57/60） of the cervical cancer group was 3 -5 points. The elastographic scores of cervix ≥ 3 points as the truncated value to diagnosis the cervical cancer,the sensitivity of transvaginal real-time ultrasound imaging was 95.00% , specificity was 92.13 %. The elastographic scores of cervix in cervical cancer group, lesion group and the control group were （3.87 ± 0.86） points, （2.05± 0.73 ） points, （ 1.20± 0.59 ） points, the score of cervical cancer group were significantly higher than those of lesion group and the control group （ P 〈 0.05 ）. Conclusion The elastic imaging of normal cervix, cervical precancerous lesion and cervical cancer has different characteristic features, transvaginal real-time ultrasound imaging can be used as an effective method for the diagnosis of cervical cancer.