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超声造影定量分析在盆腔良恶性肿瘤鉴别诊断中的临床价值

Clinical value of quantitative analysis of contrast-enhanced ultrasonography in the differential diagnosis of benign and malignant pelvic tumors.

作者信息

Fan Qiyun, Zhang Yin, Wang Fa, Chen Hui, Xie Qianru, Ji Bing, Qiu Ting, Shentu Weihui, Wang Hongying, Wu Yingheng

机构信息

Department of Medical Ultrasonics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

Quant Imaging Med Surg. 2023 Oct 1;13(10):6636-6645. doi: 10.21037/qims-23-582. Epub 2023 Aug 24.

Abstract

BACKGROUND

Cervical cancer, endometrial cancer, and ovarian cancer are among the top 10 most common cancers in women, with ovarian cancer in particular being considered a "silent killer". Therefore, early detection, diagnosis, and treatment constitute important means of care for women's health. This study investigated the clinical value of the quantitative analysis of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of benign and malignant pelvic tumors.

METHODS

CEUS was performed on 151 patients with pelvic masses. Subsequently, a qualitative diagnosis was completed using the image enhancement features and tumor parameters. A multiparametric analysis of CEUS images was performed, which included the following parameters: arrival time (AT), time to peak (TTP), peak intensity (PI), and ascent slope (AS). In addition, the qualitative diagnostic efficiency of CEUS was assessed in a multiparametric analysis, and the results were compared with pathological findings.

RESULTS

The patients in the malignant group were older (P=0.001) and had larger lesion PI values (P<0.01) than those in the benign group. The PI difference (PI) and the AS difference (AS) showed statistical differences (P<0.01) between the myometrium and lesion tissues in the same patient. Moreover, the PI and AS showed the largest receiver operating characteristic (ROC) curve and area under the ROC curve (AUC), with sensitivities of 90.9% and 91.7% and specificities of 86.4% and 72.5%, respectively.

CONCLUSIONS

The quantitative analysis of CEUS provides a new, simpler, and more accurate method for the differential diagnosis of benign and malignant pelvic masses in clinical practice. The sensitivities and specificities of PId and ASd were higher compared to other parameters from the same patient.

摘要

背景

宫颈癌、子宫内膜癌和卵巢癌是女性十大常见癌症之一,其中卵巢癌尤其被视为“沉默杀手”。因此,早期检测、诊断和治疗是关爱女性健康的重要手段。本研究探讨了超声造影(CEUS)定量分析在盆腔良恶性肿瘤鉴别诊断中的临床价值。

方法

对151例盆腔肿块患者进行CEUS检查。随后,利用图像增强特征和肿瘤参数完成定性诊断。对CEUS图像进行多参数分析,包括以下参数:达峰时间(AT)、峰值时间(TTP)、峰值强度(PI)和上升斜率(AS)。此外,在多参数分析中评估CEUS的定性诊断效率,并将结果与病理结果进行比较。

结果

恶性组患者年龄大于良性组(P = 0.001),病变PI值大于良性组(P < 0.01)。同一患者的子宫肌层与病变组织之间的PI差值(PI)和AS差值(AS)存在统计学差异(P < 0.01)。此外,PI和AS的受试者操作特征(ROC)曲线及ROC曲线下面积(AUC)最大,敏感性分别为90.9%和91.7%,特异性分别为86.4%和72.5%。

结论

CEUS定量分析为临床实践中盆腔良恶性肿块的鉴别诊断提供了一种新的、更简单且更准确的方法。与同一患者的其他参数相比,PId和ASd的敏感性和特异性更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d3e/10585541/a3576f212b35/qims-13-10-6636-f1.jpg

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