Department of Gynecology and Obstetrics Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China.
J Ultrasound Med. 2021 Sep;40(9):1851-1861. doi: 10.1002/jum.15568. Epub 2020 Nov 20.
To explore the clinical value of real-time shear wave ultrasonic elastography in diagnosing the depth of infiltrating muscularis of endometrial cancer.
Seventy-one patients with stage I endometrial cancer infiltrating the myometrium and 37 patients with normal physical examination were enrolled and divided into three groups: endometrial cancer superficial muscle infiltration group, endometrial cancer deep muscle infiltration group, and normal control group. After completing 2-dimensional ultrasound examination, each patient switched to the real-time shear wave elastography mode to measure the elasticity values Emax, Emean, and Esd.
For control group, comparison of elastic modulus values between superficial muscular layer near the intimal surface and the deep muscular layer near the serosa surface showed no difference (P > 0.05). For endometrial cancer superficial muscular infiltration group, significant difference was found regarding the elastic modulus values of infiltrated muscular layer and uninfiltrated muscular layer (Emax and Emean) without difference for Esd (P > 0.05). A significant difference of elastic modulus was observed between control group and deep myometrial infiltration group (P < 0.05) without difference of Emean or Emax but with difference of Esd. The accuracy in diagnosing muscular layer infiltration was 78.9% for Emax cutoff and 82.5% for Emean cutoff. The rate of using Emax ≥32.22 kPa or Emean ≥27.54 kPa as the ultrasound standard for diagnosing myometrium infiltration was 92.9%. The accuracy for the diagnosis of muscular layer infiltration was 96.1% for Emax cutoff, 94.1% for Emean cutoff and 86.3% for Esd cutoff.
Real-time shear wave elastography is helpful to determine the depth of infiltrating myometrium of endometrial cancer.
探讨实时剪切波弹性成像在诊断子宫内膜癌肌层浸润深度中的临床价值。
纳入 71 例Ⅰ期子宫内膜癌肌层浸润患者和 37 例正常体检者，分为子宫内膜癌浅肌层浸润组、子宫内膜癌深肌层浸润组和正常对照组。完成二维超声检查后，每位患者切换至实时剪切波弹性成像模式，测量弹性值 Emax、Emean 和 Esd。
正常对照组，内膜表面浅层和浆膜面深层的弹性模量值无差异（P＞0.05）。子宫内膜癌浅肌层浸润组，浸润肌层与未浸润肌层的弹性模量值差异有统计学意义（Emax 和 Emean），Esd 无差异（P＞0.05）。正常对照组与深肌层浸润组的弹性模量差异有统计学意义（P＜0.05），但 Emean 或 Emax 无差异，Esd 有差异。Emax 截断值诊断肌层浸润的准确率为 78.9%，Emean 截断值的准确率为 82.5%。Emax≥32.22 kPa 或 Emean≥27.54 kPa 作为超声诊断肌层浸润的标准，其符合率为 92.9%。Emax 截断值、Emean 截断值和 Esd 截断值诊断肌层浸润的准确率分别为 96.1%、94.1%和 86.3%。
实时剪切波弹性成像有助于判断子宫内膜癌肌层浸润深度。
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