超声造影定量参数在子宫内膜癌诊断中的应用价值

目的：探讨超声造影血流灌注参数在子宫内膜癌诊断中的应用价值,分析其与临床病理特征的关系。方法：选取2019年3月-2022年2月本院子宫内膜癌患者104例,子宫内膜良性疾病患者90例(子宫内膜息肉68例,黏膜下肌瘤22例),所有患者均进行术前超声造影检查,以病理结果为金标准,分析超声造影血流灌注参数曲线上升时间(RT)、达峰时间(TTP)、峰值强度(PI)和平均通过时间(MTT)在子宫内膜癌疾病诊断和临床病理特征评估中的应用价值。结果：子宫内膜癌RT、TTP、MTT短于子宫内膜良性病变,PI大于子宫内膜良性病变(P＜0.05)；血流灌注参数RT、PI、TTP、MTT联合检测鉴别诊断子宫内膜癌与子宫内膜良性病变ROC曲线下面积为0.903高于各项指标单独检测曲线下面积0.742、0.634、0.804、0.657(P＜0.05)；子宫内膜癌FIGO分期Ⅲ～Ⅳ期患者RT、TTP、MTT时间短于Ⅰ～Ⅱ期患者,PI强度大于Ⅰ～Ⅱ期患者(P＜0.05)；血流灌注参数RT、PI、TTP、MTT联合检测鉴别子宫内膜癌FIGO分期Ⅰ～Ⅱ期、Ⅲ～Ⅳ期ROC曲线下面积为0.842高于各项指标单独检测曲线下面积0.727、0.641、0.753、0.627(P＜0.05)；子宫内膜癌淋巴结转移患者RT、TTP、MTT时间短于未发生淋巴结转移患者,PI强度大于未发生淋巴结转移患者(P＜0.05)；血流灌注参数RT、PI、TTP、MTT联合检测评估子宫内膜癌淋巴结转移的发生ROC曲线下面积为0.832高于各项指标单独检测曲线下面积0.675、0.659、0.726、0.704(P＜0.05)。结论：采用超声造影进行血流灌注定量检查能够反映子宫内膜癌病灶血流情况,对临床中诊断和病理分期、淋巴结转移评估等具有指导意义。

Application value of contrast-enhanced ultrasound perfusion parameters in the diagnosis of endometrial carcinoma and their relationship with clinicopathological characteristics

Objective: To explore the application value of contrast-enhanced ultrasound perfusion parameters in the diagnosis of endometrial carcinoma and analyze their relationship with clinicopathological characteristics. Methods: A total of 104 patients with endometrial carcinoma and 90 patients with benign endometrial diseases (68 cases with endometrial polyps and 22 cases with submucosal fibroids) in the hospital were enrolled between March 2019 and February 2022. All underwent preoperative contrast-enhanced ultrasonography. Taking pathological results as the golden standard, application value of ultrasonography parameters rise time (RT), time to peak (TTP), peak intensity (PI), mean transit time (MTT)] in the diagnosis of endometrial carcinoma and evaluation of clinicopathological characteristics was analyzed. Results: RT, TTP and MTT in endometrial carcinoma were shorter than those in benign endometrial lesions, and PI was greater than that in benign endometrial lesions (P<0.05). The area under ROC curve (AUC) of RT combined with PI, TTP and MTT in the differential diagnosis of endometrial carcinoma and benign endometrial lesions was 0.903, greater than that of single index (0.742, 0.634, 0.804, 0.657, P<0.05). RT, TTP and MTT in patients with FIGO staging at stages III-IV were shorter than those at stages I-II, and PI was higher than that at stages I-II (P<0.05). AUC of RT combined with PI, TTP and MTT in the differential diagnosis of stages I-II and stages III-IV was 0.842, greater than that of single index (0.727, 0.641, 0.753, 0.627, P<0.05). RT, TTP and MTT in patients with lymph node metastasis were shorter than those without metastasis, and PI was higher than that without metastasis (P<0.05). AUC of RT combined with PI, TTP and MTT for evaluating lymph node metastasis was 0.832, greater than that of single index (0.675, 0.659, 0.726, 0.704, P<0.05). Conclusion: Quantitative examination of blood perfusion by contrast-enhanced ultrasound can reflect the blood flow in endometrial carcinoma, which has guidance significance for clinical diagnosis, pathological staging and evaluation of lymph node metastasis.