常规超声联合剪切波弹性成像技术在子宫内膜病变鉴别诊断中的应用价值

Application value of conventional ultrasound combined with shear wave elastography in the differential diagnosis of endometrial lesions

目的分析常规超声联合剪切波弹性成像(SWE)技术在子宫内膜病变鉴别诊断中的应用价值。方法选取2022年6月至2023年10月荆门市人民医院妇科门诊接诊的100例疑似子宫内膜病变患者作为研究对象,分别给予常规超声、SWE、常规超声联合SWE检查,以手术病理活检诊断结果作为金标准,比较常规超声、SWE、常规超声联合SWE的诊断效能(准确率、灵敏度、特异度),Kappa检验常规超声、SWE、常规超声联合SWE与金标准的一致性。比较良性、恶性病灶血流信号特征及杨氏模量值。结果病理活检诊断确诊恶性46例、良性54例;常规超声联合SWE诊断准确率、灵敏度均高于常规超声、SWE,差异有统计学意义(P<0.05),常规超声联合SWE的特异度与常规超声、SWE比较差异无统计学意义;常规超声、SWE与金标准的一致性一般(Kappa值=0.612、0.695),常规超声联合SWE与金标准的一致性较好(Kappa值=0.762)。恶性病灶杨氏模量值最大值、平均值均高于良性病灶,差异有统计学意义(P<0.05)。结论常规超声联合SWE可提高子宫内膜良、恶性病变诊断准确率、灵敏度、特异度,血流信号越丰富、杨氏模量值越高,病灶恶性程度越高。

Objective To analyze the application value of conventional ultrasound combined with shear wave elastography(SWE)in the differential diagnosis of endometrial lesions.Methods A total of 100 patients with suspected endometrial lesions admitted to the gynecological outpatient department of Jingmen Second People's Hospital from June 2022 to October 2023 were selected as the study subjects,routine ultrasound,SWE,and routine ultrasound combined with SWE were respectively given,and the diagnostic results of surgical pathological biopsy were taken as the gold standard.The diagnostic efficacy(accuracy,sensitivity and specificity)among conventional ultrasound,SWE,and conventional ultrasound combined with SWE were compared,and the consistency of conventional ultrasound,SWE,and conventional ultrasound combined with SWE was tested by Kappa.The blood flow signal characteristics and Young's modulus of benign and malignant lesions were compared.Results Pathological biopsy confirmed 46 malignant cases and 54 benign cases.The diagnostic accuracy and sensitivity of conventional ultrasound combined with SWE were higher than those of conventional ultrasound and SWE,the difference was statistically significant(P<0.05);there was no significant difference in the specificity of conventional ultrasound combined with SWE compared with conventional ultrasound and SWE.The consistency between conventional ultrasound and SWE with pathological biopsy was general(Kappa=0.612,0.695),while the consistency between conventional ultrasound combined with SWE with pathological biopsy was good(Kappa=0.762).The maximum and average values of Young's modulus in malignant lesions were higher than those in benign lesions,and the difference was statistically significant(P<0.05).Conclusion Conventional ultrasound combined with SWE can improve the diagnostic accuracy,sensitivity and specificity of benign and malignant endometrial lesions,the richer the blood flow signal and the higher the value of Young's modulus,the higher the malignant degree of the lesion.