三维能量多普勒超声检测宫颈高级别鳞状上皮病变

发布时间：2018-09-07 06:29

【摘要】：目的前瞻性研究三维能量多普勒超声(3DPDUS)检测宫颈高级别鳞状上皮内病变(HSIL)的临床价值。方法收集120例疑似宫颈病变患者,排除宫颈有明显肿块者。对所有患者均行二维常规经阴道超声和3DPDUS检查,对照病理学结果进行分析。采用4Dview VOCAL软件获得宫颈三维血管参数,包括血管化指数(VI)、血流指数(FI)及血管化血流指数(VFI)。以病理结果为金标准,采用ROC曲线分析3DPDUS诊断HSIL的敏感度和特异度,并计算曲线下面积。结果 120例中,病理证实HSIL患者59例,二维超声诊断12例,3DPDUS诊断36例。HSIL患者的三维血管参数均高于宫颈良性病变患者,差异均有统计学意义(P均0.05)。二维超声诊断HSIL的敏感度和特异度分别为20.33%(12/59)、75.40%(46/61),3DPDUS诊断HSIL的敏感度和特异度分别为61.01%(36/59)、81.96%(50/61)。ROC曲线分析显示当VI为3.38时,曲线下面积为0.883,特异度和敏感度分别为68.0%和72.9%,当FI为32.18时,曲线下面积为0.723,特异度和敏感度分别为68.2%和76.3%,当VFI为1.18时,曲线下面积为0.888,特异度和敏感度分别95.5%和72.9%。结论 VFI可用于临床早期鉴别宫颈HSIL。
[Abstract]:Objective to study the clinical value of three-dimensional power Doppler ultrasound (3DPDUS) in the detection of high-grade squamous intraepithelial lesions (HSIL) of the cervix. Methods 120 cases of suspected cervical lesions were collected and the patients with obvious cervical masses were excluded. Two-dimensional conventional transvaginal ultrasound and 3DPDUS were performed in all patients, and the pathological results were analyzed. Three dimensional cervical vascular parameters, including vascularization index (VI),) blood flow index (FI) and vascularized blood flow index (VFI).), were obtained by 4Dview VOCAL software. ROC curve was used to analyze the sensitivity and specificity of 3DPDUS in diagnosing HSIL, and the area under the curve was calculated. Results among the 120 cases, 59 cases were confirmed by pathology and 12 cases were diagnosed by 2D ultrasound in 36 cases. The three dimensional vascular parameters of patients with HSIL were significantly higher than those of patients with benign cervical lesions (all P 0. 05). The sensitivity and specificity of two-dimensional ultrasound in the diagnosis of HSIL were 20.33% (12 / 59) and 75.40% (46 / 61) respectively. The sensitivity and specificity of 3DPDUS in diagnosing HSIL were 61.01% (36 / 59) 81.96% (50 / 61) .ROC analysis showed that when VI was 3.38, the area under the curve was 0.883, the specificity and sensitivity were 68.0% and 72.9%, respectively, when FI was 32.18, The area under the curve was 0.723, the specificity and sensitivity were 68.2% and 76.33.When VFI was 1.18, the area under the curve was 0.888, the specificity and sensitivity were 95.5% and 72.9%, respectively. Conclusion VFI can be used in early clinical differential diagnosis of cervical HSIL..
【作者单位】：哈尔滨医科大学附属第二医院超声医学科;
【基金】：黑龙江省博士后科研启动基金(LBH-Q13121)
【分类号】：R445.1;R737.33

【相似文献】