经阴道实时超声弹性成像在宫颈癌前病变与宫颈癌鉴别诊断中的价值

Value of Transvaginal Real-time Ultrasound Elastography in the Differential Diagnosis of Cervical Precancerous Lesions and Cervical Cancer

目的:探讨经阴道实时超声弹性成像在宫颈癌前病变与宫颈癌鉴别诊断中的价值。方法:选取2016年5月-2017年5月本院收治的宫颈癌患者50例、宫颈癌前病变患者50例分别设为研究组和试验组,另选宫颈正常查体者50例为对照组。三组均经阴道实时超声弹性成像检查,分析检查结果。结果:研究组超声弹性成像评分均高于试验组、对照组(P<0.05);研究组超声弹性成像评分为3、4、5分比例明显高于试验组、对照组,比较差异均有统计学意义(P<0.05);将超声弹性成像评分≥3分作为截断值时,诊断正确率、敏感性及特异性分别为92.0%、94.0%、91.0%;超声弹性成像诊断宫颈癌病灶长径、横径、前后径长度与病理结果比较差异均无统计学意义(P>0.05);研究组弹性应变率比值为(2.73±1.28),明显高于试验组的(0.81±0.14),比较差异有统计学意义(P<0.05)。结论:经阴道实时超声弹性成像能够有效鉴别诊断宫颈癌前病变与宫颈癌,且可较为准确判断宫颈癌病灶大小,具有较高临床应用价值。

Objective：To investigate transvaginal real-time elastography in the differential diagnosis of cervical precancerous lesions and cervical cancer.Method：A total of 50 cases of cervical cancer and 50 cases of cervical precancerous lesions admitted in our hospital from May 2016 to May 2017 were selected as study group and experimental group respectively,and 50 cases of normal cervix were selected as control group.They were examined by transvaginal real-time ultrasound elastography,and the results were analyzed.Result：The scores of ultrasound elastography in study group were higher than those of experimental group and control group（P〈0.05）.The proportion of 3, 4 and 5 points of ultrasound elastography in study group were significantly higher than those of experimental group and control group,the differences were statistically significant（P〈0.05）.Ultrasound elastography score ≥3 points as a cut-off value,the diagnostic accuracy,sensitivity and specificity were 92.0%,94.0%,91.0% respectively.The length,transverse diameter and anteroposterior diameter of cervical cancer lesions diagnosed by transvaginal real-time ultrasound elastography were compared with pathological results,the differences were not statistically significant（P〉0.05）.The elastic strain rate ratio of study group was（2.73±1.28）,which was significantly higher than（0.81±0.14） of experimental group,the difference was statistically significant（P〈0.05）.Conclusion：Transvaginal real-time ultrasound elastography can effectively identify the precancerous lesion and cervical cancer,and can accurately determine the lesion size of cervical cancer,which has high clinical value.