腹部高频及腔内超声联合应用方法及其对提高输尿管癌诊断率的价值

Combined application of high frequency and intracavitary ultrasonography and its value in improving the diagnosis rate of ureteral carcinoma

目的分析腹部高频与腔内超声联合应用方法及其诊断输尿管癌效果,为临床治疗提高参考。方法选取我院2015年3月~2016年6月收治手术病例确诊为输尿管癌患者51例为研究对象,患者开展超声检查,整理患者超声检查资料,比较腔内超声、腹部高频和联合诊断价值。结果所有患者均存在不同程度输尿管扩张、肾积水等。输尿管癌超声诊断肾实质萎缩变薄,梗阻部位输尿管腔狭窄或者中断,下段肿瘤部分自输尿管口呈现菜花状,多数肿瘤低回声,少数中等回声。腹部高频和腔内超声确诊病例数差异不明显(P>0.05),联合诊断确诊比例显著高于腹部高频和腔内超声单一使用(P<0.05)。腹部高频和腔内超声两种诊断方法敏感性、特异性均无明显差异(P>0.05),联合诊断敏感性和特异性显著高于其他两种诊断方法(P<0.05)。联合诊断结果显示,5例无肾盂扩张,最小肿瘤体积1.8×1.1×1.1 mm^3,肿瘤最大体积4.3×3.1×2.1 mm^3,肿瘤直径与扩张程度无明显相关性。肿瘤6例发生在上段,35例中下段,10例下段。结论腹部高频与腔内超声联合诊断输尿管癌准确性更高,比常规腹部探头检查更加具有应用价值。

Objective To analyze the combined application of abdominal high frequency and intracavitary ultrasound and its effect on the diagnosis of ureteral carcinoma, so as to provide the references for clinical treatment. Methods 51 patients with ureteral carcinoma who were diagnosed by operation in our hospital from March 2015 to June 2016 were selected as the study subjects. The patients were examined by ultrasound, and the data of ultrasound examination were collected. The values of intracavitary ultrasound, abdominal high frequency and the combined diagnosis were compared.Results All the patients had varying degrees of ureteral dilatation, hydronephrosis and other symptoms. According to the ultrasound diagnosis of ureteral carcinoma, there were atrophy and thinning in renal parenchyma, and ureteral stenosis or interruption at obstruction site. The form of cauliflower was shown from the ureteral mouth at the lower part of the tumor. The majority of the tumor had low echo, and a few had moderate echo. There was no significant difference in the number of diagnosed cases between abdominal high frequency and intracavitary ultrasound（P〉0.05）. The diagnosis ratio of combined diagnosis was significantly higher than that of single application of abdominal high frequency and intracavitary ultrasonography（P〈0.05）. There were no significant differences in the sensitivity and specificity between the two methods of abdominal high frequency and intracavitary ultrasound（P 〉0.05）. The sensitivity and specificity of the combined diagnosis were significantly higher than those of the other two diagnostic methods（P〈0.05）. The combined diagnosis results showed that 5 cases were without renal pelvis expansion. The smallest tumor volume was 1.8×1.1×1.1 mm^3,and the largest tumor volume was 4.3 ×3.1×2.1 mm^3. There was no significant correlation between tumor diameter and degree of dilation. 6 cases of tumor were observed in the upper section, 35 cases in the middle to lower section, and 10 cases in the lower section. Conclusion Abdominal high frequency combined with intracavitary ultrasound in the diagnosis of ureteral carcinoma has a higher accuracy, which has a higher application value than the conventional abdominal probe examination.