South Egypt Cancer Institute, Assiut University, Egypt, Asyut, Egypt.
Women Health Hospital, Assiut University, Egypt, Asyut, Egypt.
Br J Radiol. 2021 Mar 1;94(1119):20201195. doi: 10.1259/bjr.20201195. Epub 2021 Feb 2.
(a) To comparatively evaluate the performance of grayscale ultrasound features, power Doppler (PD) blood flow characteristics, and gel infusion sonography (GIS) in diagnosing endometrial cancer during real-time examination, (b) to compare the performance of real-time diagnosis of endometrial cancer by experienced observers with offline analysis by blinded observers using similar sonographic criteria during review of cine loop clips.
152 females with post-menopausal bleeding (PMB) had ET ≥ 4 mm at first-line ultrasound were included. Two experienced radiologists evaluated endometrial patterns at real-time evaluation (grayscale ultrasound, PD, and GIS), then examinations were stored as video clips for later evaluation by two less-experienced radiologists. The reference standard was hysteroscopy (HY) and/or hysterectomy with the histopathological examination. The area under (AUC) the receiver operating characteristic (ROC) curve was calculated to assess the diagnostic performance for the prediction of endometrial cancer.
Among 152 females with ET ≥ 4 mm at first line TVUS, 88 (57.9%) patients had endometrial cancer on final pathologic analysis. Real-time ultrasound criteria (ET ≥ 5 mm with the presence of irregular branching endometrial blood vessels or multiple vessels crossing EM or areas with densely packed color-splash vessels with non-intact or interrupted EMJ at the grayscale ultrasound and/or GIS) correctly diagnosed 95% of endometrial cancers with 92% diagnostic efficiency.There is comparable accuracy of real-time evaluation (96%) and offline analysis (92%) after the exclusion of poor quality videos from the analysis. The diagnostic criteria showed good to an excellent agreement between real-time ultrasound and offline analysis.
When real-time ultrasound is performed with good technique, utilizing multiple parameters, it is possible to diagnose endometrial cancer with a high degree of accuracy and reproducibility.
when real-time ultrasound is performed with good technique, utilizing multiple parameters, it is possible to diagnose endometrial cancer with a high degree of accuracy and reproducibility.
(a) 比较灰阶超声特征、能量多普勒（PD）血流特征和凝胶输注超声（GIS）在实时检查中诊断子宫内膜癌的性能，(b) 比较经验丰富的观察者实时诊断子宫内膜癌的性能与在回顾电影循环剪辑时使用类似超声标准进行盲法观察者离线分析的性能。
纳入 152 名绝经后出血（PMB）的女性，一线超声 ET≥4mm。两名经验丰富的放射科医生在实时评估（灰阶超声、PD 和 GIS）时评估子宫内膜形态，然后将检查作为视频剪辑存储，以便两名经验较少的放射科医生进行后续评估。参考标准是宫腔镜（HY）和/或子宫切除术及组织病理学检查。计算受试者工作特征（ROC）曲线下面积（AUC）评估预测子宫内膜癌的诊断性能。
在一线 TVUS 中 ET≥4mm 的 152 名女性中，88 名（57.9%）患者最终病理分析为子宫内膜癌。实时超声标准（ET≥5mm，存在不规则分支子宫内膜血管或多条血管穿过 EM 或 EMJ 不完整或中断处密集排列彩色飞溅血管的区域）正确诊断了 95%的子宫内膜癌，诊断效率为 92%。在排除分析中质量较差的视频后，实时评估（96%）和离线分析（92%）的准确性相当。诊断标准在实时超声和离线分析之间具有良好到极好的一致性。
当实时超声技术良好，利用多个参数时，可高度准确且可重复地诊断子宫内膜癌。
当实时超声技术良好，利用多个参数时，可高度准确且可重复地诊断子宫内膜癌。
