经阴道超声联合盆底超声检查对宫颈癌的诊断价值

The diagnostic value of transvaginal ultrasonography combined with pelvic floor ultrasonography in diagnosis of cervical cancer

目的:探究经阴道超声联合盆底超声检查在宫颈癌诊断中的临床价值。方法:选取淄博市妇幼保健院2020年8月—2022年7月收治的90例疑似宫颈癌患者,所有患者均采用经阴道超声联合盆底超声检查。对比不同宫颈病变患者超声参数指标,以病理学检查为“金标准”,分析经阴道超声联合盆底超声检查对宫颈癌的诊断价值。结果:宫颈癌患者收缩期最大流速(PSV)、舒张末期流速(EDV)均高于宫颈良性病变患者,宫颈最大径及血流阻力指数(RI)值均低于宫颈良性病变患者,差异有统计学意义(P<0.05)。“金标准”检查明确Ⅰ期13例,Ⅱ期14例,Ⅲ期11例,Ⅳ期4例。经阴道超声联合盆底超声检查在宫颈癌分期Ⅳ期中诊断准确度最高,其次为Ⅰ期、Ⅱ期、Ⅲ期。联合检查在宫颈癌Ⅰ期、Ⅳ期中的诊断一致性良好(Kappa值=0.836、0.774),在宫颈癌Ⅱ期、Ⅲ期中的诊断一致性尚可(Kappa值=0.667、0.556)。结论:经阴道超声联合盆底超声在宫颈诊断中应用价值较高,可更好反映病灶血供情况,有效提升各分期诊断效能,并可明确各分期与“金标准”一致性,为临床手术方案制定等提供有效参考。

Objective To explore the clinical value of transvaginal ultrasonography combined with pelvic floor ultrasonography in the diagnosis of cervical cancer.Methods A total of 90 patients with suspected cervical cancer were selected from Zibo Maternal and Child Health Hospital from August 2020 to July 2022.All patients were examined by transvaginal ultrasonography combined with pelvic floor ultrasonography.The diagnostic value of transvaginal ultrasonography combined with pelvic floor ultrasonography for cervical cancer was analyzed by comparing ultrasound parameters of patients with different cervical lesions,and pathological examination was the"gold standard".Results The maximum systolic flow velocity(PSV)and end-diastolic flow velocity(EDV)of cervical cancer patients were higher than those of benign cervical lesions,and the maximum cervical diameter and blood flow resistance index(RI)were lower than those of benign cervical lesions,the difference was statistically significant(P<0.05).The"gold standard"examination confirmed 13 cases of stage I,14 cases of stageⅡ,11 cases of stageⅢ,and 4 cases of stageⅣ.The diagnostic accuracy of transvaginal ultrasonography combined with pelvic floor ultrasonography was the highest in stage IV of cervical cancer,followed by stageⅠ,stageⅡand stageⅢ.The diagnostic consistency of combined examination was good in stage I and stageⅣcervical cancer(Kappa=0.836,0.774),and reasonable in stage II and stageⅢcervical cancer(Kappa=0.667,0.556).Conclusion Transvaginal ultrasonography combined with pelvic floor ultrasonography has high application value in cervical staging diagnosis,which can better reflect the blood supply of the lesion,effectively improve the diagnostic efficiency of each stage,and clarify the consistency between each stage and the"gold standard",providing effective reference for clinical surgical planning.