高频超声联合超声造影对阴囊肿块良恶性的鉴别价值

Value of high-frequency ultrasound combined with contrast-enhanced ultrasound in differentiating the benign and malignant masses of scrotal cysts

目的探究高频超声联合超声造影对阴囊肿块良恶性的鉴别价值,为临床诊治提供参考。方法选取2020年1月至2023年12月郑州大学第一附属医院收治的94例阴囊肿块患者作为研究对象,经病理检查结果分为恶性病变组54例和良性病变组40例,以病理检查结果为金标准,分析高频超声联合超声造影对阴囊肿块良恶性的鉴别价值。结果恶性病变组患者的阴囊肿块长径、短径分别为(5.67±2.85)cm、(3.73±2.04)cm,明显长于良性病变组的(3.84±2.56)cm、(2.31±1.45)cm,恶性病变组患者阴囊肿块位于睾丸位置的比例为96.30%,明显高于良性病变组的35.00%,差异均有统计学意义(P<0.05);高频超声、超声造影诊断阴囊肿块良恶性的准确率分别为75.53%(71/94)、77.66%(73/94),两种诊断方式联合的准确率为94.68%(89/94),明显高于两者单独诊断,差异有统计学意义(P<0.05);良、恶性阴囊肿块的形态、钙化、内部回声、血流比较,差异均有统计学意义(P<0.05),但边界和回声分布比较差异均无统计学意义(P>0.05);良、恶性阴囊肿块的增强强度、增强均匀度、造影剂进入与消退方式、增强形式比较,差异均有统计学意义(P<0.05);阴囊肿块良性病变平均渡越时间为(28.04±8.65)s,明显短于恶性病变的(49.21±15.29)s,开始增强时间为(20.53±7.17)s,明显晚于恶性病变的(17.14±4.91)s,差异均有统计学意义(P<0.05);阴囊肿块良性病变的峰值强度为(50.17±8.64)dB,明显高于恶性病变的(45.41±4.31)dB,AUC值、上升支斜率分别为(1043.82±304.25)mm^(2)、(0.21±0.17)dB/s,明显低于恶性病变的(1400.59±340.08)mm^(2)、(0.90±0.20)dB/s,差异均有统计学意义(P<0.05)。结论高频超声联合超声造影应用于阴囊肿块良恶性鉴别的准确率较高,不同病变性质阴囊肿块的高频超声、超声造影表现有明显差异。

Objective To explore the value of high-frequency ultrasound combined with contrast-enhanced ultrasound in differentiating the benign and malignant nature of scrotal masses,and provide a reference for clinical diagnosis and treatment.Methods A total of 94 patients with scrotal masses admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2023 were selected as the research subjects.They were divided into a malignant lesion group of 54 cases and a benign lesion group of 40 cases according to the pathological examination results.Taking the pathological examination results as the gold standard,the value of high-frequency ultrasound combined with contrast-enhanced ultrasound in differentiating benign and malignant scrotal masses was analyzed.Results The length and width of the scrotal mass in patients with malignant lesions were(5.67±2.85)cm and(3.73±2.04)cm,respectively,which were significantly longer than(3.84±2.56)cm and(2.31±1.45)cm in patients with benign lesions;the proportion of scrotal mass located in the testis in patients with malignant lesions was 96.30%,which was significantly higher than 35.00% in patients with benign lesions;the differences were statistically significant(P<0.05).The accuracy of high-frequency ultrasound combined with contrast-enhanced ultrasound in diagnosing the benign and malignant nature of scrotal masses was 94.68%(89/94),respectively,which were significantly higher than 75.53%(71/94)of high-frequency ultrasound alone and 77.66%(73/94)of contrast-enhanced ultrasound alone(P<0.05).The morphology,calcification,internal echo,and blood flow of benign and malignant scrotal masses showed statistically significant differences(P<0.05).However,there was no significant difference in the boundary and echo distribution(P>0.05).The enhancement intensity,uniformity of enhancement,entry and subsidence of contrast agents,and enhancement pattern showed statistically significant differences between benign and malignant scrotal masses(P<0.05).The average transit time of benign lesions in scrotal masses was(28.04±8.65)s,which was significantly shorter than(49.21±15.29)s of malignant lesions;the initial enhancement time was(20.53±7.17)s,which was significantly later than(17.14±4.91)s of malignant lesions;the differences were statistically significant(P<0.05).The peak intensity of benign lesions in scrotal masses was(50.17±8.64)dB,which was significantly higher than(45.41±4.31)dB of malignant lesions;the AUC value and the rising slope were(1043.82±304.25)mm^(2) and(0.21±0.17)dB/s,respectively,which were significantly lower than(1400.59±340.08)mm^(2) and(0.90±0.20)dB/s of malignant lesions;the differences were statistically significant(P<0.05).Conclusion The accuracy of high-frequency ultrasound combined with contrast-enhanced ultrasound is higher in the identification of benign and malignant scrotal masses,and the manifestations of high-frequency ultrasound and contrast-enhanced ultrasound are significantly different in different pathological properties of scrotal masses.