Zhu Yicheng, Deng Shuhao, Zhang Yuan, Jiang Quan
Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China.
Exp Ther Med. 2018 Mar;15(3):2343-2346. doi: 10.3892/etm.2018.5720. Epub 2018 Jan 8.
The application value of conventional ultrasound and ultrasonic elastography (UE) in preoperative diagnosis and combined diagnosis of malignant anus neoplasms was investigated. One hundred and twenty patients, whose mass was detected by digital rectal examination, were examined using UE and conventional ultrasound before operation, and the results were compared with those of histopathological examinations after operation, so that the accuracy and imaging features of UE as well as UE combined with conventional ultrasound in diagnosing malignant anus neoplasm were analyzed. Among the 120 patients, 77 were diagnosed with benign lesions and 43 were diagnosed with malignant lesions via pathological diagnosis for anal canal lesion surgery. Conventional ultrasound before operation showed that 53 patients were diagnosed with benign lesions and 26 with malignant lesions. Compared with that in the pathological diagnosis results, the diagnostic accordance rate in preoperative conventional ultrasound was 65.8%. Through UE diagnosis, 66 patients had benign lesions and 39 patients had malignant lesions. Compared with that in the pathological diagnosis results, the diagnostic accordance rate in preoperative UE was 87.5%. After the examination via UE combined with conventional ultrasound before operation, 71 patients were diagnosed with benign lesions and 40 patients were diagnosed with malignant lesions; compared with that in the pathological diagnosis results, the diagnostic accordance rate was 92.5%. In terms of mass qualitative diagnosis, the sensitivity and specificity of conventional ultrasound were 60.5 and 68.8%, respectively; those of UE were 90.7 and 85.7%, respectively, and those of UE combined with conventional ultrasound were 93.0 and 92.2%, respectively. According to the analysis results of receiver operating characteristic (ROC) curve, the area under curve (AUC) of malignant anus neoplasm diagnosed via UE was 0.732 [95% confidence interval (95% CI), 0.211-2.534], the AUC via conventional ultrasound was 0.695 (95% CI, 0.517-0.932), and that via UE combined with conventional ultrasound was 0.823 (95% CI, 0.146-4.643). In conclusion, examinations utilizing UE combined with conventional ultrasound can increase the preoperative diagnostic accordance rate in malignant anus neoplasm, which can be used as an effective method for preoperative diagnosis of malignant anus neoplasm.
探讨了常规超声及超声弹性成像(UE)在肛管恶性肿瘤术前诊断及联合诊断中的应用价值。对120例经直肠指诊发现肿物的患者在术前进行UE及常规超声检查,并将结果与术后组织病理学检查结果进行比较,分析UE以及UE联合常规超声诊断肛管恶性肿瘤的准确性及影像学特征。120例患者中,经肛管病变手术病理诊断,77例为良性病变,43例为恶性病变。术前常规超声显示,53例诊断为良性病变,26例诊断为恶性病变。与病理诊断结果相比,术前常规超声诊断符合率为65.8%。经UE诊断,66例为良性病变,39例为恶性病变。与病理诊断结果相比,术前UE诊断符合率为87.5%。术前经UE联合常规超声检查后,71例诊断为良性病变,40例诊断为恶性病变;与病理诊断结果相比,诊断符合率为92.5%。在肿块定性诊断方面,常规超声的敏感性和特异性分别为60.5%和68.8%;UE的敏感性和特异性分别为90.7%和85.7%,UE联合常规超声的敏感性和特异性分别为93.0%和92.2%。根据受试者工作特征(ROC)曲线分析结果,UE诊断肛管恶性肿瘤的曲线下面积(AUC)为0.732[95%置信区间(95%CI),0.211 - 2.534],常规超声的AUC为0.695(95%CI,0.517 - 0.932),UE联合常规超声的AUC为0.823(95%CI,0.146 - 4.643)。综上所述,UE联合常规超声检查可提高肛管恶性肿瘤术前诊断符合率,可作为肛管恶性肿瘤术前诊断的有效方法。