腹部超声、阴道超声联合剪切波弹性成像诊断宫颈癌的价值

Value of abdominal ultrasound and transvaginal ultrasound combined with SWE in the diagnosis of cervical cancer

目的:研究腹部超声、阴道超声联合剪切波弹性成像(SWE)诊断宫颈癌的价值。方法:将2018年1月—2020年1月行宫颈病变筛查的94例患者纳为研究对象,患者均获得确切病理检查结果,且均行腹部超声、阴道超声及SWE成像检查,以病理检查结果作为“金标准”,分析腹部超声、阴道超声联合SWE成像在诊断宫颈癌中的价值。结果:病理检查提示94例受检者中宫颈癌56例,宫颈上皮内瘤变(CIN)23例,宫颈正常15例;SWE成像提示,53%的宫颈癌患者病灶组织内弹性图像填充颜色以红色为主,并夹杂着橙色与绿色;41%宫颈癌患者病灶组织内弹性图像填充颜色以橙色为主,并夹杂红色与绿色;6%的宫颈癌患者病灶组织内弹性图像呈亮绿色;CIN患者及宫颈正常者宫颈组织弹性图像填充颜色均为蓝色。宫颈癌患者弹性模量最大值及平均值均显著高于CIN患者及宫颈正常者(P<0.05),CIN患者及功能正常者弹性模量最大值及平均值均无显著性差异(P>0.05);以病理诊断结果作为“金标准”,各检查方式单独应用时,以腹部超声鉴别良恶性宫颈病变效力最低,SWE成像在鉴别良恶性宫颈病变中效力最高,阴道超声检查效能居中,三者联合诊断能有效提高诊断效果,联合诊断灵敏度、特异度及准确度分别为96.43%、97.37%和96.81%。结论:腹部超声、经阴道超声及SWE成像在诊断宫颈癌中均具有一定的效力,但以SWE诊断效力最高,三者联合诊断可有效弥补三种检查方法的不足,进一步提高宫颈癌临床诊断效果。

Objective:To investigate the value of abdominal ultrasound and transvaginal ultrasound combined with shear wave elastography(SWE)in the diagnosis of cervical cancer.Methods:A total of 94 patients who underwent cervical lesion screening in our hospital from January 2018 to January 2020 were enrolled.All patients underwent pathological examination,abdominal ultrasound,transvaginal ultrasound and SWE imaging.Taking the results of pathological examinations as the“gold standard”,the value of abdominal ultrasound,transvaginal ultrasound combined with SWE imaging in the diagnosis of cervical cancer was analyzed.Results:Pathological examination among 94 individuals showed that there were 56 cases of cervical cancer,23 cases of cervical intraepithelial neoplasia(CIN)and 15 normal cases.In SWE images,the central part of the lesion in 53%cervical cancer patients was mainly red,with some focal orange and green areas;the central part of the lesion in41%cervical cancer patients was mainly orange,with some focal red and green areas,and the central part of the lesion in the rest 6%cervical cancer patients was mainly green,while the central part of the lesion of CIN patients and those with normal cervix was mainly blue.The maximum and average elastic modulus of patients with cervical cancer were significantly higher than those of CIN patients and those with normal cervix(P<0.05),while the maximum and average elastic modulus of CIN patients and those with normal cervix showed no significant difference(P>0.05).With pathological diagnosis as the“gold standard”,SWE imaging had the highest effect in differentiating benign from malignant cervical lesions,followed by transvagi-nal ultrasound,and abdominal ultrasound had the lowest effect in differentiating benign from malignant cervical lesions.The sensitivity,specificity and accuracy of the combined diagnosis were 96.43%,97.37%and 96.81%,respectively.Conclusion:Abdominal ultrasound,transvaginal ultrasound and SWE imaging all have certain efficacy in the diagnosis of cervical cancer,but SWE has the highest diagnostic efficacy,while combined diagnosis of the three can effectively improve the clinical diag-nosis effect of cervical cancer.