经阴道实时剪切波弹性成像对宫颈疾病的诊断价值
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摘要
目的探讨经阴道实时剪切波弹性成像(SWE)诊断宫颈疾病的价值。方法将89例行经阴道常规超声、SWE及TCT检查,术后病理证实的宫颈病变患者,根据病理结果分为宫颈恶性肿瘤组69例、宫颈良性肿瘤组20例,34例宫颈正常者设为对照组,回顾分析比较三组间剪切波速度值的差异。结果对照组正常宫颈的剪切波速度最大值、平均值分别为(3.26±0.31)m/s和(2.84±0.21)m/s;良性肿瘤组的剪切波速度最大值、平均值分别为(3.90±0.40)m/s和(3.52±0.54)m/s,恶性肿瘤的剪切波速度最大值、平均值分别为(5.25±1.10)m/s和(4.90±1.11)m/s,组间两两比较差异均有统计学意义(P均<0.05)。宫颈恶性肿瘤组中,SWE测量的病变大小明显大于常规超声测量值,P<0.05。结论经阴道实时剪切波弹性成像有助于鉴别诊断宫颈疾病、判断肿瘤浸润范围,为临床分期和治疗提供有效的帮助。
Objective To explore the value of transvaginal real-time shear wave elastography(SWE)in the diagnosis of cervical disease.Methods Retrospective analysis of 89 cases of transvaginal conventional ultrasound,SWE and TCT,and postoperative pathologically confirmed cervical lesions,according to pathological results were divided into 69 cases of cervical cancer group,cervical benign tumor group of 20 cases,34 cases of normal cervix For the control group.The shear wave velocity of normal cervix,cervical benign and malignant tumors was measured and compared among the 3 group.Results The maximum and mean shear wave velocity of normal cervix was(3.26±0.31)m/s and(2.84±0.21)m/s,of benign tumors was(3.90±0.40)m/s and(3.52±0.54)m/s,while of malignant tumors was(5.25±1.10)m/s and(4.90±1.11)m/s,respectively.The differences of the maximum and mean shear wave velocity between each two groups were statistically significant(all P<0.05).In the cervical malignant tumor group,the lesion size measured by SWE was significantly larger than the conventional ultrasound measurement,P<0.05.Conclusions Transvaginal real-time shear wave elastography is useful for the differential diagnosis of cervical diseases,to determine the extent of tumor invasion,and to provide effective help for clinical staging and treatment.
Objective To explore the value of transvaginal real-time shear wave elastography(SWE)in the diagnosis of cervical disease.Methods Retrospective analysis of 89 cases of transvaginal conventional ultrasound,SWE and TCT,and postoperative pathologically confirmed cervical lesions,according to pathological results were divided into 69 cases of cervical cancer group,cervical benign tumor group of 20 cases,34 cases of normal cervix For the control group.The shear wave velocity of normal cervix,cervical benign and malignant tumors was measured and compared among the 3 group.Results The maximum and mean shear wave velocity of normal cervix was(3.26±0.31)m/s and(2.84±0.21)m/s,of benign tumors was(3.90±0.40)m/s and(3.52±0.54)m/s,while of malignant tumors was(5.25±1.10)m/s and(4.90±1.11)m/s,respectively.The differences of the maximum and mean shear wave velocity between each two groups were statistically significant(all P<0.05).In the cervical malignant tumor group,the lesion size measured by SWE was significantly larger than the conventional ultrasound measurement,P<0.05.Conclusions Transvaginal real-time shear wave elastography is useful for the differential diagnosis of cervical diseases,to determine the extent of tumor invasion,and to provide effective help for clinical staging and treatment.
引文
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[10] YING L,LIN X,XIE Z L,et al.Clinical utility of acoustic radiation force impulse imaging for identification of malignant liver lesions:a meta-analysis[J].European Radiology,2012,22(12):2798-2805.
[2] LIU Z,JING H,HAN X,et al.Shear wave elastography combined with the thyroid imaging reporting and data system for malignancy risk stratification in thyroid nodules[J].Oncotarget,2017,8(26):43406-43416.
[3] LEE H Y,LEE J H,JI H S,et al.Shear wave elastography using ultrasound:effects of anisotropy and stretch stress on a tissue phantom andin vivoreactive lymph nodes in the neck[J].Ultrasonography,2016,36(1):25-32.
[4]郝少云,欧冰,钟文景,等.弹性成像对新版BI-RADS-US评估乳腺肿物良恶性的价值[J].中国超声医学杂志,2015,31(4):294-295.
[5] BAKAY O A,GOLOVKO T S.Use of elastography for cervical cancer diagnostics[J].Experimental Oncology,2015,37(2):139-145.
[6] BAMBER J,COSGROVE D,DIETRICH C F,at al.EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography.Part 1:basic principles and technology[J].Ultraschall Med,2013,34:169-184.
[7] KANG B K,LEE S S,CHEONG H,et al.Shear Wave Elastography for Assessment of Steatohepatitis and Hepatic Fibrosis in Rat Models of Non-Alcoholic Fatty Liver Disease[J].Ultrasound in Medicine&Biology,2015,41(12):3205-3215.
[8]金鑫,阙艳红,王学梅,等.实时剪切波弹性成像技术定量评价正常宫颈组织[J].中国医学影像技术,2013,29(3):459-462.
[9] BOTA S,SPOREA I,SIRLI R,et al.Intra-and interoperator reproducibility of acoustic radiation force impulse(ARFI)elastography--preliminary results[J].Ultrasound in Medicine&Biology,2012,38(7):1103-1108.
[10] YING L,LIN X,XIE Z L,et al.Clinical utility of acoustic radiation force impulse imaging for identification of malignant liver lesions:a meta-analysis[J].European Radiology,2012,22(12):2798-2805.