用对比增强的超声波用于宫癌分期的腹横和直肠横超声波:可靠性研究
Juan Zhang1, Jiang-Dong Xiang1, Chao Jia2
1Department of Gynaecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ultrasound in medicine & biology
|July 26, 2023
概括
与对比度增强的超声波 (CEUS) 提高了宫癌分期的准确性. 将跨直肠US (TR-US) 与TR-CEUS结合起来,可以提供病理水平的一致性,类似于早期疾病的MRI.
科学领域:
- 医疗成像医学成像
- 在瘤学瘤学.
- 诊断性的超声波检查
背景情况:
- 精确的宫癌分期对于有效的治疗计划至关重要.
- 传统的超声波 (美国) 在评估瘤特征和范围方面存在局限性.
- 对比增强超声波 (CEUS) 提供了瘤血管性和异质性的增强可视化.
研究的目的:
- 评估跨直肠对比增强超声波 (TR-CEUS) 与宫癌手术后病理学的一致性.
- 评估CEUS与常规US相结合的实用性,用于分期经过手术治疗的宫癌 (IB和II阶段).
主要方法:
- 对39名患有IB和II期子宫癌的患者进行了回顾性研究,这些患者接受了整体子宫切除术.
- 获得横腹部 (TA-US/CEUS) 和横直肠 (TR-US/CEUS) 图像,并进行MRI.
- 评估瘤大小和阶段,与病理发现进行比较.
主要成果:
- CEUS提高了TA-US对瘤直径评估的可靠性 (ICC 0.6720.735).
- 在有或没有CEUS的情况下,TR-US显示出良好的可靠性 (ICC 0.796,0.780).
- 与TR-CEUS结合的TR-US显示了瘤阶段化术后病理的最高一致性 (κ=0.785),与MRI (κ=0.789) 相比.
- CEUS揭示了瘤异质性; perfusion 缺陷在较大 (> 2 cm) 和差异化瘤中更常见.
结论:
- 在国际妇科和产科联合会 (International Federation of Gynecology and Obstetrics) 中,CEUS在与TA-US和TR-US一起使用时有助于早期宫癌 (IB,IIA) 的分期.
- TR-US和TR-CEUS的组合提供了可靠的分期,与MRI相似,用于手术治疗宫癌.
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