超声造影与核磁共振成像对宫颈癌病灶和侵犯程度评估的一致性

目的 探究超声造影(contrast-enhanced ultrasonography，CEUS)与磁共振成像(magnetic resonance imaging,MRI)在评估宫颈癌病灶大小和侵犯情况中的一致性。 方法 选择2017年1月—2018年11月宁波市鄞州人民医院收治的宫颈癌患者76例，分别应用MRI增强扫描和CEUS检查，比较2种检查对病灶大小以及周围侵犯情况评估的一致性。 结果 一致性分析显示，MRI和CEUS评估病灶的左右径、纵轴直径和前后径具有较好的一致性(ICC=0.949、0.802、0.866)，其中，MRI和CEUS的病灶左右径和前后径测量值的平均差值间无统计学差异(P=0.253、0.744)，CEUS病灶纵轴直径测量值明显低于MRI(P=0.002)。CEUS与MRI评估阴道侵犯情况的诊断一致率为88.16%，具有较高的一致性(Kappa=0.761)。CEUS与MRI评估宫旁组织侵犯情况的诊断一致率为88.16%，具有较高的一致性(Kappa=0.799)。CEUS与MRI评估膀胱和直肠侵犯情况的诊断一致率为77.63%，具有较高的一致性(Kappa=0.719)。 结论 超声造影与MRI在评估宫颈癌病灶大小和侵犯情况中具有较高的一致性，但CEUS对于病灶纵轴直径和膀胱直肠侵犯为中等一致性。 

Consistency analysis of contrast-enhanced ultrasonography and Magnetic resonance imaging in assessment of lesion size and invasion for cervical cancer

Objective To investigate the consistency of contrast-enhanced ultrasonography (CEUS) with MRI in assessing the lesion size and invasion of cervical cancer. Methods Seventy six patients with cervical cancer admitted to our hospital from January 2017 to November 2018 were enrolled into this study. MRI enhanced scan and CEUS were used to compare the size of the lesions and the consistency of the surrounding invasion. Results The consistency analysis showed that MRI and CEUS had good consistency in transverse diameter, longitudinal diameter and anteroposterior diameter of the lesion (ICC=0.949, 0.802, 0.866). There was no statistical difference between the mean differences (P=0.253, 0.744), and the CEUS lesions were significantly lower than the MRI (P=0.002). The diagnostic rate of CEUS and MRI for vaginal invasion was 88.16% with high agreement (Kappa=0.761). The concomitant rate of CEUS and MRI for the assessment of parametrical tissue invasion was 88.16% with high agreement (Kappa=0.799). The diagnostic agreement rate for CEUS and MRI assessment of bladder and rectal invasion was 77.63% with high agreement (Kappa=0.719). Conclusion Contrast-enhanced ultrasonography have a good agreement with MRI in assessing the size and invasion of cervical cancer, but CEUS showed similar moderate agreement with MRI in cranial-caudal diameter, bladder or rectal invasion.