超声造影技术评估宫颈癌预后应用价值研究

目的探讨超声造影(CEUS)技术评估宫颈癌预后的应用价值。方法选取2010年12月至2016年4月收治的宫颈癌患者40例,根据是否存在风险预后因素分为中-高风险组(15例)与低风险组(25例)。比较两组患者的CEUS表现与时间-强度曲线(TIC)参数,绘制受试者工作特征曲线(ROC)并计算增强强度(EI)最佳诊断阈值。结果宫颈癌CEUS表现以非均匀性高增强为主,两组增强水平与增强分布比较,差异无统计学意义(P>0.05);中-高风险组灌注缺损多于低风险组,差异有统计学意义(P<0.05)。两组增强时间(AT)与达峰时间(TTP)差异无统计学意义(P>0.05);中-高风险组峰值强度(PI)与增强强度(EI)高于低风险组,差异有统计学意义(P<0.05)。EI在最佳诊断阈值25.75 d B时,评估宫颈癌存在中-高风险预后因素的敏感度为93.3%、特异度为74.0%、准确度为77.5%。结论 CEUS技术在评估宫颈癌预后中具有一定的临床应用价值。

The value of contrast-enhanced ultrasound in evaluating the prognosis of cervical cancer

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)in the evaluating the prognosis of cervical cancer. Methods A retrospective study was performed on 40 cases of patients with cervical cancer who were admitted from December 2010 to April 2016. According to the results of pathological prognostic risk factors,patients were divided into the middle-high risk group(n =15)and low risk group(n =25). The relationship between the contrast-enhanced ultrasound feature and the acoustical timeintensity curve(TIC)quantified parameters,prognostic factors of these two groups were analyzed. A receiver-operating characteristic curve(ROC)was drew according to enhanced intensity(EI). Results The CEUS of cervical cancer mostly showed inhomogeneous hyper- enhance,and enhancement intensity and homogeneity had no statistically significant difference of the between the two groups(P > 0. 05). The focal perfusion defect in the middle-high risk group was more common than that in the low risk group(P <0. 05). The arrival time(AT)and time to peak(TTP)between the two groups had no statistically significant difference(P >0. 05). The peak intensity (PI)and enhanced intensity(EI)in the middle-high risk group was higher than that in the low-risk group(P <0. 05). The optimal diagnostic threshold of EI for evaluation of middle-high risk was 25. 75 dB,with the sensitivity,specificity and accuracy of 93. 3% , 74. 0% and 77. 5% ,respectively. Conclusion CEUS technology has a certain clinical value in evaluating cervical cancer prognosis.