三维超声在子宫内膜癌诊断及术前分期中的应用价值

Application value of three-dimensional ultrasonography for diagnosis and preoperative staging of endometrial carcinoma

目的探究三维超声在子宫内膜癌诊断及术前分期中的应用价值。方法选取2018年1月至2020年12月接收的180例疑似子宫内膜癌患者作为研究对象,所有患者均进行三维超声及病理检查。分析检查结果,并分析子宫内膜癌三维超声分期与病理分期的符合率。结果180例疑似子宫内膜癌患者经病理检查结果显示,68.33%确诊为子宫内膜癌,浆液性乳头状子宫内膜癌占4.07%,子宫内膜样腺癌占95.93%。123例子宫内膜癌患者血流分级为0级占4.07%,Ⅰ级占39.84%,Ⅱ级占30.89%,Ⅲ级占25.20%。超声影像学图像显示,63.41%的病灶形态不规则,60.16%的内膜周边低回声晕中断,12.20%宫颈受累,80.49%的内膜增厚>12 mm,16.26%阴道受累,9.76%直肠、膀胱受累,79.67%显示中心血管,61.79%见血管分支。三维超声对子宫内膜癌的诊断灵敏度为96.75%(119/123),特异度为96.49%(55/57),准确度为96.67%(174/180),阳性预测值为98.35%(119/121),阴性预测值为93.22%(55/59)。三维超声对子宫内膜癌Ⅰa期、Ⅰb期、Ⅰc期、Ⅱ期、Ⅲ期、Ⅳ期诊断与病理分期的符合率比较,差异无统计学意义(P>0.05)。结论三维超声应用于子宫内膜癌诊断中,可较好反映患者的病情以及疾病分期情况,有较高的诊断灵敏度、特异度、准确度,意义重大。

Objective To investigate the application value of three-dimensional ultrasonography for diagnosis and preoperative staging of endometrial carcinoma.Methods A total of 180 patients with suspected endometrial carcinoma admitted from January 2018 to December 2020 were selected as the research objects,and all patients underwent three-dimensional ultrasonography and pathological examination.The examination results were analyzed,and the coincidence rate between three-dimensional ultrasonography staging and pathological staging of endometrial carcinoma was analyzed.Results The results of pathological examination of 180 patients with suspected endometrial carcinoma showed that 68.33%of them were diagnosed with endometrial carcinoma,4.07%were serous papillary endometrial carcinoma and 95.93%were endometrioid adenocarcinoma.The 123 patients with endometrial carcinoma were classified as grade 0(4.07%),gradeⅠ(39.84%),gradeⅡ(30.89%)and gradeⅢ(25.20%).Ultrasound imaging images showed that 63.41%of the lesions were irregular in shape,60.16%of the periintimal hypoechoic halo was interrupted,12.20%of the cervix was involved,80.49%of the intimal thickening>12 mm,16.26%of the vagina was involved,9.76%of the rectum and bladder were involved,79.67%showed central blood vessels,61.79%showed vascular branches.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of three-dimensional ultrasonography in the diagnosis of endometrial carcinoma were 96.75%(119/123),96.49%(55/57),96.67%(174/180),98.35%(119/121)and 93.22%(55/59),respectively.There was no significant difference in the coincidence rate between the diagnosis of endometrial carcinoma in stageⅠa,stageⅠb,stageⅠc,stageⅡ,stageⅢ,stageⅣby three-dimensional ultrasonography and pathological stage(P>0.05).Conclusion The three-dimensional ultrasonography applied in the diagnosis of endometrial carcinoma can better reflect the patients'condition and disease staging,and has high diagnostic sensitivity,specificity and accuracy,which is of great significance.