Department of Radiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
Department of Radiology, Oncology Hospital, Ankara, Turkey.
Diagn Interv Imaging. 2016 Apr;97(4):425-31. doi: 10.1016/j.diii.2015.11.007. Epub 2015 Dec 17.
To assess the value of transvaginal sonographic elastography (TSE) in discriminating between endometrial hyperplasia and endometrial carcinoma.
A total of 61 women with post-menopausal hemorrhage and/or normal TSE were included. There were 32 women (mean age: 53.1±14.1 years) with endometrial hyperplasia, 14 women (mean age: 60.0±14.0 years) with endometrial carcinoma and 15 women (mean age: 51.9±7.8 years) with no endometrial disease who served as a control group. The strain index (SI) values obtained during TSE in each group were compared using Mann-Whitney U test and Kruskal-Wallis analysis of variance test.
The mean SI values were 0.80 (range: 0.30-1.30) in the endometrial hyperplasia group, 1.80 (range: 0.80-3.20) in the endometrial carcinoma group and 1.00 (range: 0.50-4.00) in the control group. No significant differences were found between endometrial hyperplasia group and control group, but significant differences were found between endometrial carcinoma and hyperplasia groups and between endometrial carcinoma and control groups (P<0.0001). TSE had a sensitivity of 81.3%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 70% in differentiating endometrial carcinoma from endometrial hyperplasia. The area under ROC curve (AUC) to distinguish between endometrial carcinoma and endometrial hyperplasia was 0.933 (95% CI, 0.853-1.000) using a threshold SI value of 1.05. The AUC to distinguish between endometrial carcinoma and control was 0.881 (95% CI, 0.735-1.000) using a threshold SI value of 1.15.
Our results indicate that TSE can provide important information that help discriminate between endometrial carcinoma and endometrial hyperplasia.
评估经阴道超声弹性成像（TSE）在鉴别子宫内膜增生和子宫内膜癌中的价值。
共纳入 61 例绝经后出血和/或 TSE 正常的患者。其中 32 例患者（平均年龄：53.1±14.1 岁）为子宫内膜增生，14 例患者（平均年龄：60.0±14.0 岁）为子宫内膜癌，15 例患者（平均年龄：51.9±7.8 岁）为无子宫内膜疾病患者作为对照组。采用 Mann-Whitney U 检验和 Kruskal-Wallis 方差分析比较各组 TSE 获得的应变指数（SI）值。
子宫内膜增生组的平均 SI 值为 0.80（范围：0.30-1.30），子宫内膜癌组为 1.80（范围：0.80-3.20），对照组为 1.00（范围：0.50-4.00）。子宫内膜增生组与对照组之间无显著差异，但子宫内膜癌组与增生组、子宫内膜癌组与对照组之间差异显著（P<0.0001）。TSE 鉴别子宫内膜癌与子宫内膜增生的灵敏度为 81.3%，特异度为 100%，阳性预测值为 100%，阴性预测值为 70%。当 SI 值为 1.05 时，鉴别子宫内膜癌与子宫内膜增生的 ROC 曲线下面积（AUC）为 0.933（95%CI，0.853-1.000）。当 SI 值为 1.15 时，鉴别子宫内膜癌与对照组的 AUC 为 0.881（95%CI，0.735-1.000）。
本研究结果表明，TSE 可提供重要信息，有助于鉴别子宫内膜癌和子宫内膜增生。
