CAJ | 학술논문

目的：探讨经阴道超声弹性成像鉴别诊断宫颈占位性病变良恶性的价值。方法对95例拟诊为宫颈占位性病变患者行经阴道超声弹性成像检查，参照改良5分法评分标准进行评分，并对病变部位进行弹性应变率比值（elastic strain ratios，SRs）检测，将2种方法得到的结果与病理结果对照；SRs 法的 ROC 曲线下面积和最佳临界点通过 ROC 曲线评价。结果95例患者中：病理证实为良性病变45例，SRs 为1．87±0．70；恶性病变50例，SRs 为3．72±0．61，二者 SRs 比较差异有统计学意义（P ＜0．05）。改良5分评分法评分1～2分44例，3～5分51例；SRs法 ROC 曲线下面积为0．982，约登指数最大值为0．896，ROC 曲线最佳临界点为2．83，SRs≥2．8349例，SRs＜2．8346例；SRs 法诊断的敏感性、特异性和准确性分别为94．0％、95．6％和94．7％，改良5分法评分诊断的敏感性、特异性和准确性分别为94．0％、91．1％和92．6％，2种方法对宫颈占位性病变的诊断价值比较，差异无统计学意义（P ＞0．05）。结论经阴道超声弹性成像对宫颈占位性病变良恶性有较高的鉴别诊断价值。
목적：탐토경음도초성탄성성상감별진단궁경점위성병변량악성적개치。방법대95례의진위궁경점위성병변환자행경음도초성탄성성상검사，삼조개량5분법평분표준진행평분，병대병변부위진행탄성응변솔비치（elastic strain ratios，SRs）검측，장2충방법득도적결과여병리결과대조；SRs 법적 ROC 곡선하면적화최가림계점통과 ROC 곡선평개。결과95례환자중：병리증실위량성병변45례，SRs 위1．87±0．70；악성병변50례，SRs 위3．72±0．61，이자 SRs 비교차이유통계학의의（P ＜0．05）。개량5분평분법평분1～2분44례，3～5분51례；SRs법 ROC 곡선하면적위0．982，약등지수최대치위0．896，ROC 곡선최가림계점위2．83，SRs≥2．8349례，SRs＜2．8346례；SRs 법진단적민감성、특이성화준학성분별위94．0％、95．6％화94．7％，개량5분법평분진단적민감성、특이성화준학성분별위94．0％、91．1％화92．6％，2충방법대궁경점위성병변적진단개치비교，차이무통계학의의（P ＞0．05）。결론경음도초성탄성성상대궁경점위성병변량악성유교고적감별진단개치。
ABSTRACT:Objective To evaluate the value of transvaginal ultrasound elastography in the dif-ferential diagnosis of benign and malignant cervical space-occupying lesions.Methods Transvagi-nal ultrasound elastography was performed in 95 patients with suspected cervical space-occupying lesions.The results achieved by the improved 5-point scoring system and elastic strain ratios (SRs)determination were compared with the pathological results.The area under the receiver-op-erating characteristic(ROC)curve of SRs method and the optimal cut-off point were evaluated by ROC curve.Results Among the 95 patients,histopathology showed benign lesions in 45 and ma-lignant lesions in 50.There was a significant difference in SRs between patients with benign le-sions(1.87±0.70)and patients with malignant lesions(3.72±0.61)(P <0.05).The results of improved 5-point scoring system showed scores 1-2 in 44 and scores 3-5 in 51.The area under the curve of ROC was 0.982.The maximal value of Youden index was 0.896.The optimal cut-off point was 2.83.SRs≥2.83 was found in 49 patients and SRs<2.83 in 46 patients.The sensitivi-ty,specificity and accuracy were,respectively,94.0%,95.6% and 94.7% for SRs measurement,and 94.0%,91.1% and 92.6% for improved 5-point scoring system.There was no difference in diagnostic value for cervical space-occupying lesions between the two methods(P >0.05).Conclu-sion Transviginal ultrasound elastography is valuable in differential diagnosis of benign and ma-lignant cervical space-occupying lesions.