超声基础声像图与造影声像图诊断子宫肌瘤的ROC曲线分析

目的:用受试者操作特征分析方法(ROC)评价超声造影中基础声像图与造影声像图对子宫肌瘤的诊断价值.方法:临床疑似子宫肌瘤症状患者110例,行常规经腹超声检查后进入造影检查条件进行实时超声造影检查.超声造影采用六氟化硫微泡造影荆和对比脉冲序列成像技术.两位经验丰富的超声医师(受试者)分别在常规超声和超声造影奈件下对检查结果独立做出诊断,记录诊断结果并用SPSS统计软件绘制受试者操作特征曲线图评估常规超声和超声造影对病变的鉴别诊断价值,应用Kappa值评估受试者之间的一致性.结果:ROC曲线结果显示两位受试者在常规超声条件下曲线下面积分别为0.645和0.707,超声造影条件下曲线下面积为0.965和0.985,差异均存在显著性意义(P＜0.001).受试者之间的一致性结果显示超声造影较常规超声高,它们的Kappa值分别为0.816和0.662.结论:超声造影总体上提高了对子宫肌瘤的诊断能力.

ROC Analysis of Baseline and Contrast-enhanced Ultrasound in the Diagnosis of Uterine Leiomyomas

Objective:To compare the diagnostic value of baseline ultrasound and contrast-enhanced ultrasound in patients with uterine leiomyomas by receiver operating characteristic(ROC) analysis.Methods:One hundred and ten patients suspected of having uterine leiomyomas were examined by baseline ultrasound and contrast-enhanced ultrasound mode of contrast pulse sequencing with a sulphur hexafluoride-filled microbubble contrast agent.Two investigators who had much clinical experience reviewed the images before and after contrast agent administration.The diagnostic performance was evaluated by ROC curve analysis that was made with spss 11.5 and the interobserver agreement was also analyzed.Results:ROC analysis revealed that there were significant differences of the areas under the ROC curve of both two investigators(P<0.01).Their areas under the ROC curve were 0.647 and 0.707 at baseline ultrasound versus 0.965 and 0.985 at contrast-enhanced ultrasound,respectively.The interobserver agreement showed that the Kappa value of contrast-enhanced ultrasound(K=0.816) is higher than that of baseline ultrasound(K=0.662).Conclusion:The image of contrast-enhanced ultrasound can improve significantly the diagnostic performance of uterine leiomyomas.