本文選題：宮頸癌 + 經(jīng)陰道三維能量多普勒　； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的：探討三維能量多普勒超聲及超聲彈性成像技術(shù)對(duì)宮頸癌的診斷價(jià)值,并比較兩種方法的優(yōu)越性。 資料與方法：研究對(duì)象包括宮頸癌患者組(共40個(gè)病灶),CIN患者組(共25個(gè)病灶)和正常對(duì)照組(20例健康志愿者)�；颊咝g(shù)前用GE公司的logic E9超聲診斷儀,具備三維能量多普勒技術(shù)及超聲彈性成像技術(shù),選擇陰道探頭,檢查時(shí)囑患者排空膀胱取截石位,將探頭緩慢置于陰道后穹窿部,進(jìn)行橫向、縱向等多方位、多角度掃查,先于二維超聲模式下觀察宮頸形態(tài)、大小、內(nèi)部回聲以及有無占位病變,宮頸粘膜層及部分陰道情況等.同時(shí)觀察子宮頸旁情況,宮頸腫塊內(nèi)部及周邊血流動(dòng)力學(xué)特征,以及血管分布情況。然后切換至彈性成像模式對(duì)宮頸行實(shí)時(shí)彈性成像檢查,健康體檢女性則對(duì)整個(gè)宮頸進(jìn)行彈性成像檢查。 參照Thomas提出的5級(jí)評(píng)分法對(duì)宮頸癌患者、CIN患者及正常對(duì)照組女性的宮頸彈性成像圖像進(jìn)行分析,獲得圖像彈性評(píng)分值。再切換到三維能量多普勒程序,通過VOCAL系統(tǒng)用計(jì)算機(jī)程序法自動(dòng)得到三維直方圖,從而獲得腫瘤血流參數(shù)VI、FI、VFI,健康體檢女性則測(cè)量整個(gè)宮頸的血流參數(shù)VI、FI、VFI。探討宮頸癌患者、CIN組、正常對(duì)照組之間的彈性圖像評(píng)分是否有差異,統(tǒng)計(jì)分析宮頸癌患者組、CIN組、正常對(duì)照組之間三維能量多普勒血流參數(shù)VI、FI、VFI是否有差異,有差異時(shí)通過ROC曲線獲得截?cái)帱c(diǎn)。最后探討比較經(jīng)陰道常規(guī)二維超聲、三維能量多普勒超聲與超聲彈性成像技術(shù)對(duì)宮頸癌的診斷的準(zhǔn)確度、敏感度、特異度,比較其診斷價(jià)值。 結(jié)果： (1)宮頸癌組的三維能量多普勒血流參數(shù)VI、FI、VFI高于正常對(duì)照組及CIN組,差異有統(tǒng)計(jì)學(xué)意義(P0.05) (2)宮頸癌組超聲彈性成像評(píng)分高于正常對(duì)照組與CIN組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)； (3)CIN組三維能量多普勒血流參數(shù)VI、FI、VFI與正常對(duì)照組間的差異無統(tǒng)計(jì)學(xué)意義(P0.05)；CIN組的彈性評(píng)分明顯高于正常對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05) (4)準(zhǔn)確度由高到低的順序?yàn)椋簭椥猿上袢S能量多普勒常規(guī)二維超聲。兩兩比較,彈性成像與常規(guī)二維超聲、三維能量多普勒與常規(guī)二維超聲之間準(zhǔn)確度差異有統(tǒng)計(jì)學(xué)意義(P0.05),三維能量多普勒與彈性成像之間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 敏感度由高到低的順序三維能量多普勒彈性成像常規(guī)二維超聲。兩兩比較,彈性成像與常規(guī)二維超聲、三維能量多普勒與常規(guī)二維超聲之間敏感度差異有統(tǒng)計(jì)學(xué)意義(P0.05),彈性成像與三維能量多普勒之間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 特異度由高到低的順序?yàn)閺椥猿上袢S能量多普勒常規(guī)二維超聲。兩兩比較,彈性成像與常規(guī)二維超聲、三維能量多普勒與常規(guī)二維超聲之間特異度差異有統(tǒng)計(jì)學(xué)意義(P0.05),彈性成像與三維能量多普勒之間差異無統(tǒng)計(jì)學(xué)意義(P0.05) 結(jié)論： 1、經(jīng)陰道超聲彈性成像通過提供組織的軟硬度信息,推斷宮頸病變良惡性,彈性評(píng)分在正常組、CIN組及宮頸癌組間均存在差異,對(duì)宮頸癌的診斷有良好的應(yīng)用價(jià)值。 2、經(jīng)陰道三維能量多普勒技術(shù)可提供宮頸腫塊內(nèi)的血流情況,了解局部血供特點(diǎn)及血管生成狀況,三維能量多普勒血流參數(shù)VI、FI、VFI在正常組與CIN組間無統(tǒng)計(jì)學(xué)意義差異,在宮頸癌組與CIN及正常組間差異有統(tǒng)計(jì)學(xué)意義,為宮頸癌的診斷提供重要信息。 3、經(jīng)陰道超聲彈性成像及三維能量多普勒超聲聯(lián)合二維超聲可在一定程度上提高對(duì)宮頸癌的檢出率,是對(duì)常規(guī)經(jīng)陰道二維超聲的良好補(bǔ)充。 4、超聲的彈性成像技術(shù)與三維能量多普勒相比,對(duì)宮頸癌的診斷準(zhǔn)確性、靈敏性、特異性差異無統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective: To explore the diagnostic value of three-dimensional power Doppler ultrasound and ultrasound elastography in cervical cancer, and compare the advantages of the two methods.
Data and methods: the subjects included the cervical cancer patients group (40 lesions), CIN patients group (25 lesions) and normal control group (20 healthy volunteers). The patients were used the logic E9 ultrasonic diagnostic instrument of GE company before operation, with three-dimensional energy Doppler technique and ultrasound elastography, the vaginal probe was selected, and the patient's emptying bladder was asked to check. Taking the cystotomy position, the probe was slowly placed in the posterior fornix of the vagina, transversely, longitudinally and multi azimuthal and multi angle scanning. The cervical morphology, size, internal echoes, cervical mucosa and some vagina conditions were observed in the two-dimensional ultrasound mode. The conditions of the cervix and the internal and peripheral blood flow of the cervix were observed at the same time. The dynamic characteristics, and the distribution of blood vessels. Then switch to the elastic imaging mode for real-time elastic imaging of the cervix, and the women in the health examination have an elastic imaging examination of the whole cervix.
According to the 5 grade scoring method proposed by Thomas, the cervical elastography images of cervical cancer patients, CIN patients and normal control groups were analyzed, and the value of image elasticity score was obtained. Then the three-dimensional energy Doppler program was switched to the three-dimensional energy Doppler program, and the three dimensional histogram was automatically obtained by the computer program method of the VOCAL system, and the tumor blood flow parameters VI, FI, VFI were obtained. Women in health examination measured the blood flow parameters of the whole cervix VI, FI, and VFI. to explore the difference between the elastic image scores between the patients with cervical cancer, the CIN group and the normal control group. The statistical analysis of the three dimensional energy Doppler blood flow parameters of the cervical cancer group, the CIN group and the normal control group was VI, FI, VFI, and the difference was obtained by the ROC curve when there was a difference. Finally, the accuracy, sensitivity, specificity and diagnostic value of conventional two-dimensional ultrasound, three-dimensional energy Doppler ultrasound and ultrasound elastography in the diagnosis of cervical cancer were compared.
Result錛，

本文編號(hào)：1841605