二维超声联合剪切波弹性成像技术在膀胱尿路上皮癌中的应用研究

Application of 2D ultrasound combined with SWE in bladder urothelial carcinoma

目的:探讨膀胱尿路上皮癌患者常规超声联合剪切波弹性成像技术(SWE)中弹性模量与胶原纤维面积的关系。方法:回顾性分析2017年12月—2019年12月我院收治的135例膀胱尿路上皮癌患者,根据病理诊断结果分为低度恶性潜能28例(A组)、低级别51例(B组)和高级别尿路上皮癌56例(C组)。所有患者均经常规超声联合SWE检查,比较不同分级患者常规超声特征、弹性模量值、胶原纤维面积,通过Spearman相关性分析弹性模量值与胶原纤维面积的关系。结果:三组患者常规超声检查中肿块位置、血流、内部回声、数目等比较无明显差异(P>0.05),表面情况比较有明显差异(P<0.05);三组患者E_(max)、E_(mean)比较有明显差异(P<0.05),E_(min)比较无明显差异(P>0.05);三组患者胶原纤维面积比较有明显差异(P<0.05);E_(max)值与胶原纤维面积呈正相关(r=0.700,P<0.05),Emean值与胶原纤维面积呈正相关(r=0.788,P<0.05)。结论:常规超声联合SWE测量弹性模量值可有效鉴别膀胱尿路上皮癌分级情况,且弹性模量值与胶原纤维面积呈正相关。

Objective:To investigate the relationship between elastic modulus and collagen fiber area of two-dimensional ultrasound combined with shear wave elastography(SWE)in bladder urothelial carcinoma.Methods:One hundred thirty-five patients with bladder urothelial carcinoma in our hospital from December 2017 to December 2019 were retrospectively analyzed,and divided into three groups according to pathological results:group A(low malignant potential,n=28),group B(low grade,n=51)and group C(high grade,n=56).All patients received 2D ultrasound combined with SWE.Then the 2D ultrasound characteristics,elastic modulus and collagen fiber area of patients with different grades were compared.The relationship between elastic modulus and collagen fiber area was analyzed by Spearman correlation.Results:There was no significant difference in the location,blood flow,internal echo and number of masses among the three groups(P>0.05),but there was significant difference in the surface condition(P<0.05).There was significant difference in E_(max) and E_(mean) among the three groups(P<0.05),but there was no significant difference in E_(min)(P>0.05).There was significant difference in collagen fiber area among the three groups(P<0.05),collagen fiber area was positively correlated with E_(max)(r=0.700,P<0.05)and E_(mean)(r=0.788,P<0.05).Conclusion:Application of 2D ultrasound combined with SWE can effectively differentiate the grades of bladder urothelial carcinoma,moreover,the elastic modulus is positively correlated with collagen fiber area.