直肠腔内超声血流动力学参数与剪切波弹性成像在直肠癌鉴别诊断及T分期中的应用研究

目的：探讨直肠腔内超声(ERUS)血流动力学参数与剪切波弹性成像(SWE)在直肠癌鉴别诊断及T分期中的应用价值。方法：选取128例直肠肿瘤患者的临床资料进行回顾性分析,选取时间为2018年5月至2020年6月,经病理活检确诊为直肠癌(恶性组)共68例、直肠腺瘤(良性组)共60例,均予以超声、剪切波弹性成像技术检查,对比恶性组与良性组的RI、PI、PSV、EDV等血流动力学参数、Emean指标；观察直肠癌不同分期血流动力学参数与Emean值；以及评估RI、PI、PSV、EDV、血流动力学综合参数、Emean诊断直肠癌的AUC、敏感度、特异度、约登指数。结果：恶性组的RI、PI低于良性组,而PSV、EDV、Emean均高于良性组(P＜0.05)。单因素方差分析显示,T1、T2、T2、T4期的RI、PI、PSV、EDV、Emean比较,差异存在统计学意义(P＜0.05)。ROC曲线分析显示,RI、PI、PSV、EDV、血流动力学综合参数、Emean诊断直肠癌的AUC分别为(0.914、0.747、0.666、0.839、0.999、0.996,P＜0.05)；敏感度分别为88.20%、48.50%、72.10%、64.70%、98.50%、100.00%；特异度为83.30%、100.00%、56.70%、95%、98.30%、93.30%。结论：ERUS血流动力学参数与SWE用于直肠癌鉴别诊断中均具有较高的临床价值,其中SWE可作为ERUS的辅助手段,两者联合能更好地进行T分期,为临床诊治提供客观依据。

Application of Hemodynamic Parameters of Intrarectal Ultrasound and Shear Wave Elastography in Differential Diagnosis and T Staging of Rectal Cancer

Objective: To investigate the value of hemodynamic parameters of intrarectal ultrasound (ERUS) and shear wave elastography (SWE) in the differential diagnosis and T staging of rectal cancer. Methods: The clinical data of 128 patients with rectal tumors were selected for retrospective analysis. The selection time was from May 2018 to June 2020. A total of 68 cases of rectal cancer (malignant group) and rectal adenoma (benign group) were diagnosed by pathological biopsy. ) A total of 60 cases were examined by ultrasound and shear wave elastography. The hemodynamic parameters such as RI, PI, PSV, EDV and Emean indexes of the malignant group and the benign group were compared; the hemodynamics of different stages of rectal cancer were observed Parameters and Emean value; and to evaluate RI, PI, PSV, EDV, comprehensive hemodynamic parameters, AUC, sensitivity, specificity, and Youden index for the diagnosis of rectal cancer by Emean. Results: The RI and PI of the malignant group were lower than those of the benign group, while PSV, EDV, and Emean were higher than those of the benign group (P<0.05). One-way analysis of variance showed that the differences in RI, PI, PSV, EDV, and Emean in T1, T2, T2, and T4 were statistically significant (P<0.05). ROC curve analysis showed that RI, PI, PSV, EDV, comprehensive parameters of hemodynamics, and AUC for the diagnosis of rectal cancer by Emean were (0.914, 0.747, 0.666, 0.839, 0.999, 0.996, P<0.05); the sensitivity was respectively 88.20%, 48.50%, 72.10%, 64.70%, 98.50%, 100.00%; specificity is 83.30%, 100.00%, 56.70%, 95%, 98.30%, 93.30%. Conclusion: Both ERUS hemodynamic parameters and SWE have high clinical value in the differential diagnosis of rectal cancer. SWE can be used as an auxiliary method of ERUS. The combination of the two can better perform T staging and provide objective clinical diagnosis and treatment. in accordance with.