基于声辐射力的超声弹性成像联合常规超声在子宫肌瘤中的诊断应用

Clinical application of ultrasound elasticity imaging based on acoustic radiation force combined with conventional ultrasound in the diagnosis of hysteromyoma

目的探讨基于声辐射力的超声弹性成像联合常规超声在子宫肌瘤中的诊断效能。方法回顾性分析2018年3月至2021年2月本院收治的经手术病理证实的145例子宫肌瘤患者与126例子宫腺肌瘤患者的临床病历资料,均于术前行基于声辐射力的超声弹性成像及常规超声两种检查。对比此两种检查方式对子宫肌瘤的诊断情况,并以手术病理结果为金标准,比较诊断效能。结果子宫肌瘤患者子宫动脉血流阻力指数(RI)低于子宫腺肌瘤患者(P<0.05),剪切波速度(SWV)与子宫腺肌瘤患者比较差异无统计学意义(P>0.05);常规超声、声辐射力超声弹性成像检查联合诊断子宫肌瘤的特异度(98.41%)、阳性预测值(98.56%)与准确度(96.31%)均高于各检查方式单独诊断(P<0.001),联合诊断的灵敏度(94.48%)、阴性预测值(93.94%)与各检查方式单独诊断时比较差异无统计学意义(P>0.05)。结论基于声辐射力的超声弹性成像技术联合常规超声检查在子宫肌瘤诊断中的特异度、准确度均较各检查方式独自诊断时显著升高,但联合诊断的灵敏度并未下降,联合诊断效能更佳。

Objective To explore the clinical value of ultrasound elasticity imaging based on acoustic radiation force combined with conventional ultrasound in the diagnosis of hysteromyom.Methods The clinical data of 145 patients with hysteromyoma and 126 patients with adenomyoma confirmed by surgery and pathology in our hospital from March 2018 to February 2021 were retrospectively analyzed,who were examined by ultrasound elasticity imaging based on acoustic radiation force and conventional ultrasound before operation.The diagnosis of hysteromyoma by the two methods was compared,and the results of surgical pathology were taken as the gold standard to compare the diagnostic efficacy.Results The uterine artery resistance index(RI)in patients with hysteromyoma was lower than that in patients with adenomyoma(P<0.05),but there was no significant difference in shear wave velocity(SWV)between hysteromyoma and adenomyoma(P>0.05).The specificity(98.41%),positive predictive value(98.56%)and accuracy(96.31%)of conventional ultrasound and ultrasound elasticity imaging based on acoustic radiation force in combined diagnosis of hysteromyoma were higher than those of each examination method in single diagnosis(P<0.001),but there was no significant difference in sensitivity(94.48%)and negative predictive value(93.94%)between the two examination method in combined diagnosis and single diagnosis(P>0.05).Conclusion The specificity and accuracy of ultrasound elasticity imaging based on acoustic radiation force combined with conventional ultrasound in the diagnosis of hysteromyoma are significantly higher than that of each examination method alone,but the sensitivity of the combined diagnosis is not decreased,and the combined diagnosis efficiency is higher.