经直肠常规超声与实时组织弹性成像在直肠良恶性病灶诊断中的价值

目的:评价经直肠常规超声、实时超声弹性成像在直肠良恶性肿瘤诊断中的价值。方法:对超声检查显示并经病理确诊的50例直肠病灶进行经直肠腔内扫查,获得常规二维及彩色多普勒血流超声信息,开启弹性成像获得弹性图像。结果:直肠癌动脉收缩期峰值流速(peak systolic velocity,PSV):(19.56±2.30)cm/s,RI 0.73±0.02,直肠癌PSV及阻力指数(resistance index,RI)均高于良性病灶(P<0.05),常规超声结合弹性分级诊断直肠癌的准确率84%,敏感性为83.3%,特异性为85%,均高于常规超声及弹性分级;常规超声诊断直肠癌的准确率66%,敏感性为66.7%,特异性为65%;弹性分级诊断直肠癌的准确率74%,敏感性为73.3%,特异性为75%;直肠癌T分期准确率为70%(21/30)。结论:经直肠腔内超声能为临床直肠病灶的治疗提供依据,经直肠常规超声结合超声弹性成像能提高直肠癌诊断的敏感性与特异性。

The evaluation of benign and malignant rectal lesions in transrectal conventional and real-time ultrasonic elastography

Objective： To evaluate the routine ultrasound and real-time ultrasonic elastography in the diagnosis of benign and malignant rectal lesions. Methods： 50 rectal lesions confirmed by TRUS,the ultrasonic elastography and pathology underwent rectal cavity scan. The blood ultrasound information was obtained by routine 2D and color Doppler ultrasound. The images were got by elastography. Results： The peak systolic velocities（ PSV） of rectal cancer are：（ 19. 56 ± 2. 30） cm / s,RI（ 0. 73 ± 0. 02）. The PSV of rectal cancer and resistance index（ RI） were higher than benign lesions（ P 〈 0. 05）. The accuracy,sensitivity,and specificity of the elastosonography combined with conventional ultrasoundin differentiating benign and malignant rectal cancer was 84%,83. 3%,and 85%.They are higher than that of conventional ultra-sound（ 66%,66. 7% and 65%） and elastography（ 74%,73. 3% and 75%）. The accuracy of staging rectal cancer was 70%（ 21 /30）. Conclusion： TRUS provided evidences for clinical curing. Conventional ultrasound combined elastography can improve the sensitivity and specificity of rectal cancer.