阴道超声血流灌注定量参数与宫颈癌临床分期和病灶内血管情况的关系

Vaginal ultrasound evaluation of quantitative parameters of blood perfusion and its relationship with clinical stage of cervical cancer and vascular status of lesions

目的探讨阴道超声血流灌注定量参数与宫颈癌临床分期及病灶内血管情况的关系。方法选取2016年12月至2017年12月间长庆石油勘探局矿区服务事业部职工医院收治的70例宫颈癌患者,纳入疾病组,并选取70例同期体检的健康人纳入对照组。比较疾病组不同病理分期患者阴道超声血流灌注定量参数,包括上升时间(RT)、达峰时间(TTP)、峰值强度(IMAX)、曲线下面积(AUC)、平均渡越时间(mTT)及微血管密度检测(MVD)。并分析血流灌注定量参数与MVD之间的相关性。结果疾病组IMAX、RT、TTP、mTT和AUC等均显著高于对照组,差异均有统计学意义(均P <0. 05)。血流灌流定量参数中的IMAX和AUC,以及MVD随宫颈癌分期增加而增加,差异均有统计学意义(均P <0. 05)。且IMAX和AUC与MVD之间呈正相关,差异均有统计学意义(均P <0. 05)。超声造影定量参数ROC曲线分析显示,IMAX、AUC、mTT、RT和TTP等指标ROC曲线下面积均超过0. 7,其中IMAX最高为0. 974,临界值为17. 27,AUC其次为0. 920,临界值为613. 83。结论采用阴道多普勒超声进行血流灌注定量检查能够反映宫颈癌病灶血流情况,能够反映病灶处微循环情况,对临床中诊断和病理分期等具有指导意义。

Objective To investigate the quantitative parameters of blood perfusion and its relationship with clinical stage and vascular status of cervical cancer. Methods Seventy patients with cervical cancer admitted to our hospital from December 2016 to December 2017 and 70 healthy subjects with concurrent physical examination were selected as subjects. The patients were divided into the disease group and the control group. The differences of RI and PSV levels were compared between the two groups. The quantitative parameters of blood perfusion were compared in different pathological stages of the disease group: rise time( RT),peak time( TTP),peak intensity( IMAX),area under the curve( AUC),mean transit time( m TT),and differences in MVD levels;and the correlation between quantitative parameters of blood perfusion and MVD was analyzed. Results IMAX,RT,TTP,m TT and AUC were significantly higher in the disease group than in the control group( P < 0. 05). There were differences in the quantitative parameters and MVD of different stages of cervical cancer,and IMAX,AUC,and MVD increased with the increase of cervical cancer stage( P < 0. 05). There was no statistically significant difference between RT,TTP and m TT( P > 0. 05). There was a positive correlation between IMAX,AUC and MVD( P < 0. 05). There was no significant linear correlation between TTP,RT,m TT and MVD( P < 0. 05). The ROC curve analysis of quantitative contrast parameters showed that the area under the ROC curve of IMAX,AUC,m TT,RT,TTP and other indicators exceeded 0. 7,of which the highest IMAX was 0. 974,the critical value was 17. 27,the AUC was 0. 920,and the critical value was 613. 83. Conclusion Quantitative examination of blood perfusion by vaginal Doppler ultrasound can reflect the blood flow of cervical cancer,and can reflect the microcirculation of the lesion,which has guiding significance for clinical diagnosis and pathological staging.