Che Dehong, Wei Hong, Yang Zhirong, Zhang Yanhua, Ma Shihong, Zhou Xianli
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Harbin Medical University Harbin, Heilongjiang, China.
Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University Harbin, Heilongjiang, China.
Am J Transl Res. 2019 Feb 15;11(2):1049-1057. eCollection 2019.
Transvaginal sonographic elastography can be used for the differentiation of malignant and benign lesions in different systems. Recent studies on strain elastography showed that different endometrial tissues demonstrated different stiffness characteristics. In this study, we aim to evaluate the diagnostic value of transvaginal sonographic elastography to distinguish endometrial cancer from benign masses. A prospective study was conducted on patients with suspected intracavitary uterine focal lesions, abnormal uterine bleeding for routine ultrasound examination of the pelvis. A total of 217 patients were included and underwent both conventional B-mode sonography and elastography. Endometrial lesions were categorized into 3 types for qualitative analysis and the strain ratio (SR) was measured for quantitative analysis. Pathological examinations were also conducted to establish final diagnosis. There were 104 patients diagnosed with endometrial cancer and 113 with benign lesions. All type 1 endometrial lesions were diagnosed as benign, while 95.8% of type 3 were malignant. For quantitative elastography results, the AUC for SR was 0.904 with 95% CI between 0.866 and 0.942. Using an ROC curve, the best cut-off SR value was found to be 3.02 and it could achieve a sensitivity of 81.7%, a specificity of 85%, a positive predictive value of 83.3% and a negative predictive value of 83.5%. Our results suggested that transvaginal sonographic elastography is a promising diagnostic tool for differentiating endometrial cancer from benign masses, and that SR has excellent diagnostic performance.
经阴道超声弹性成像可用于不同系统中恶性和良性病变的鉴别。最近关于应变弹性成像的研究表明，不同的子宫内膜组织表现出不同的硬度特征。在本研究中，我们旨在评估经阴道超声弹性成像在鉴别子宫内膜癌与良性肿块方面的诊断价值。对怀疑有宫腔内子宫局灶性病变、因子宫异常出血而行盆腔常规超声检查的患者进行了一项前瞻性研究。共纳入217例患者，均接受了传统B型超声检查和弹性成像检查。对子宫内膜病变进行3型分类以进行定性分析，并测量应变比（SR）以进行定量分析。还进行了病理检查以确立最终诊断。104例患者被诊断为子宫内膜癌，113例为良性病变。所有1型子宫内膜病变均被诊断为良性，而3型病变中95.8%为恶性。对于定量弹性成像结果，SR的AUC为0.904，95%CI在0.866至0.942之间。使用ROC曲线，发现最佳截断SR值为3.02，其灵敏度为81.7%，特异性为85%，阳性预测值为83.3%，阴性预测值为83.5%。我们的结果表明，经阴道超声弹性成像是鉴别子宫内膜癌与良性肿块的一种有前景的诊断工具，且SR具有优异的诊断性能。
