经阴道常规超声联合实时超声弹性成像评估宫颈癌同步放化疗疗效

Transvaginal conventional ultrasound combined with real-time elastography for evaluating the efficacy of concurrent chemoradiotherapy of cervical cancer

目的观察经阴道常规超声联合实时超声弹性成像评价宫颈癌同步放化疗(CCRT)疗效的可行性。方法收集30例经病理确诊并接受CCRT的宫颈癌患者,于CCRT前1周(治疗前)、治疗3周(治疗中)及治疗结束1个月(治疗后)行经阴道常规超声联合实时超声弹性成像检查,于治疗前及治疗后行盆腔MRI,比较治疗前、中、后各超声参数变化。依据超声及MRI表现评估宫颈癌CCRT疗效,观察二者的一致性。结果30例宫颈癌中,28例鳞癌、2例腺癌。治疗前、中、后病灶最大径差异均有统计学意义(P均<0.01);治疗前、后病灶回声、血流分级、弹性评分差异均有统计学意义(P均<0.01);治疗前、中、后病灶边界、阻力指数差异均无统计学意义(P均>0.05)。治疗后12例完全缓解、18例部分缓解,经阴道常规超声联合弹性成像评估结果与MRI结果的一致性较强(Kappa=0.72,P<0.01)。结论经阴道常规超声联合实时超声弹性成像技术可用于评估CCRT治疗宫颈癌效果。

Objective To observe the feasibility of transvaginal conventional ultrasound combined with real-time elastography for evaluating the efficacy of concurrent chemoradiotherapy(CCRT)of cervical cancer.Methods Thirty patients with cervical cancer confirmed by pathology receiving CCRT who underwent transvaginal routine ultrasound combined with real-time elastography examination 1 week before CCRT(before treatment),3 weeks during treatment(during treatment)and 1 month after CCRT(after treatment)were collected.Pelvic MR scanning were performed before and after CCRT.The characteristics of ultrasonic parameters before,during and after treatment were compared.The efficacy of CCRT was evaluated based on ultrasound and MRI,and the consistency of these 2 methods was compared.Results There were 28 cases of squamous cell carcinoma and 2 cases of adenocarcinoma.Significant differences of the maximum diameter,also of echo,blood flow classification and elastic score were detected before,during and after treatment(all P<0.01),while no significant difference of lesion boundary nor resistance index was found(both P>0.05).Among 30 patients,routine transvaginal ultrasound combined with elastography showed complete response in 12 cases and partial response in 18 cases,being in good agreement with MRI results(Kappa=0.72,P<0.01).Conclusion Transvaginal conventional ultrasound combined with real-time elastography could be used to evaluate the efficacy of CCRT of cervical cancer.