| 摘要: |
| 目的 探讨声辐射力脉冲成像技术在子宫肌瘤变性与否鉴别诊断中的应用价值。
方法 回顾性分析经手术病理结果证实子宫肌瘤患者98例共115个病灶，采用声辐射力脉冲成像技术（ARFI）术前对所有子宫肌瘤进行检测，记录检测区域的常规超声声像图、应力式弹性图像、声触诊组织成像（VTI）及剪切波速（VTQ），根据手术病理结果按是否变性分变性组和未变性组，并对数据进行统计分析。
结果 变性组和未变性组子宫肌瘤内部回声无明显差异，直径大者更容易变性。变性组应力式弹性评分、面积比及VTQ值均低于未变性组，差异有统计学意义（P＜0.05）。ARFI技术判断子宫肌瘤变性与否的ROC曲线下面积为0.72，VTQ截断值为2.52m/s ，此时判断子宫肌瘤变性的敏感度、特异度和准确率分别为65.52% 、79.10%和88.69% 。ARFI技术联合应力式弹性成像评估子宫肌瘤变性与否的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为86.36%、96.59%、70.37%、91.40%和90.43%。
结论 ARFI技术可以提供组织硬度的量化指标，与应力式弹性成像联合应用可显著提高诊断准确性，有助于子宫肌瘤变性与否的鉴别诊断。 |
| 关键词: 声辐射力脉冲成像技术 子宫肌瘤 变性 |
| DOI： |
| 投稿时间：2020-03-09修订日期：2020-05-11 |
| 基金项目: |
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| Application of acoustic radiation force impluse imaging technique in differential diagnosis of hysteromyoma degeneration |
| zhangjingjing,xuhaifei,litonghuai,zhengzhelan |
| (Echocardiography and Vascular Ultrasound Center，The First Affiliated Hospital，College of Medicine，Zhejiang University，Department of Ultrasound，Lishui People''s Hospital) |
| Abstract: |
| Objective To investigate the application of acoustic radiaction force impulse imaging technique(ARFI) in evaluating the differential diagnosis of hysteromyoma degeneration. Methods 115 cases of hysteromyoma confirmed by surgical pathology were divided into two groups: degenerated and undegenerated groups. All were detected by ARFI, and conventional ultrasound images, stress-elastic images, acoustic palpation tissue imaging（VTI）and shear wave velocity (VTQ),which were all recorded and analysed with statistics. Results There was no significant difference in the internal echo of uterine fibroids between the degeneration group and the undenatured group, and the larger diameters were more likely to be degenerated. The stress-type elastic score, area ratio and VTQ of the degeneration group were lower than those of the undenatured group, and the difference was statistically significant (P<0.05).The VTQ level of the degenerated group was lower than the undegenerated group, meanwhile the difference was statistically significant (P<0.05). The area under the ROC curve was 0.72, and the cutoff value was 2.52 m/s. At this present, the sensitivity, specificity and accuracy of hysteromyoma degeneration were 65.52%, 79.10% and 88.69 % respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ARFI technique combined with stress-type elastography for the assessment of uterine fibroid degeneration were 86.36%, 96.59%, 70.37%, 91.40% and 90.43%, respectively. ARFI technology or in combination with stress elastography can significantly improve diagnostic accuracy. Conclutions ARFI technology can provide quantitative indicators of tissue hardness, and combined with stress-based elastography can significantly improve the diagnostic accuracy and contribute to the differential diagnosis of uterine fibroids. |
| Key words: Acoustic radiation force impluse imaging technique,Hysteromyoma,degeneration |
