二维超声联合超微血管成像技术在宫颈癌 术前分期诊断中的价值

The application value of two-dimensional ultrasound combined with superb microvascular imaging in the preoperative staging of cervical carcinoma

摘要:

目的 探讨经阴道二维超声联合超微血管成像（SMI）在宫颈癌术前分期诊断中的应用价值。 方法 选取2018 年11 月—2019 年12 月广西壮族自治区人民医院收治的经病理检查确诊为宫颈癌拟手术治 疗的76 例患者。所有患者术前行阴道二维超声联合SMI 及磁共振成像（MRI）检查。以术后病理结果为金 标准，分析2 种检查方法对宫颈癌分期的准确率及敏感性。结果 76 例宫颈癌患者中，Ⅰ A 期3 例，Ⅰ B 期 57 例，Ⅱ期16 例。二维超声联合SMI 诊断宫颈癌分期总的准确率为77.6%（59/76），MRI 为73.7%（56/76）， 差异无统计学意义（P >0.05）。二维超声联合SMI 诊断Ⅰ B1、Ⅰ B2 期的准确率均高于MRI（P <0.05）。肿瘤 直径<2 cm、2 ～ <4 cm 时，二维超声联合SMI 诊断敏感性为87.5% 和93.8%，优于MRI 的84.0% 和87.5%。 结论 二维超声联合SMI 在早期宫颈癌术前分期诊断上具有价格低廉、可反复操作、无创等优势，可为宫颈 癌治疗方案的制定提供重要依据。

Abstract:

Objective To investigate the value of two-dimensional ultrasound combined with superb microvascular imaging (SMI) in the preoperative staging of cervical cancer. Methods Seventy-six patients diagnosed with cervical cancer by pathological biopsy in People's Hospital of Guangxi Zhuang Autonomous Region between November 2018 and December 2019 were selected. All patients underwent two-dimensional transvaginal ultrasound combined with SMI and MRI before operation. Taking postoperative pathological results as the gold standard, the accuracy and sensitivity of the two examination methods for the staging of cervical cancer were analyzed. Results Among 76 cases of cervical cancer, 3 cases were stage IA, 57 cases were stage IB, and 16 cases were stage Ⅱ. The overall accuracy rate in the cervical cancer staging of two-dimensional ultrasound combined with SMI was 77.6% (59/76) and that of MRI was 73.7% (56/76), between which the difference was not statistically significant (P > 0.05). The accuracy rates of two-dimensional ultrasound combined with SMI in the diagnosis of IB1 and IB2 were both higher than those of MRI (P < 0.05). When the tumor was less than 2 cm or in between 2-4 cm, the diagnostic sensitivity of two-dimensional ultrasound combined with SMI was 87.5% and 93.8% respectively, which was higher than that of MRI (84.0% and 87.5%). Conclusions Two-dimensional ultrasound combined with SMI has the advantages of low cost, allowing repeated operation as well as being non-invasive in the preoperative staging of early cervical cancer, which can provide an important basis for the formulation of treatment regimens for cervical cancer patients.