摘要
目的:探讨超声造影在子宫妊娠滋养细胞肿瘤(gestational trophoblastic neoplasia,GTN)诊断中的临床应用价值。方法:对四川大学华西第二医院2015年8月—2016年7月37例患者41个疑诊GTN病灶行常规超声和超声造影检查,根据金标准[病理和(或)临床诊断并经临床治愈]进行分组,恶性即GTN 30例34个病灶,良性即非GTN 7例7个病灶。结果:GTN造影增强模式以区域增强(44.12%,15/34)和弥漫增强(29.41%,10/34)为主。非GTN造影增强模式:妊娠物残留5例表现为区域增强,团块型子宫异位妊娠2例表现为环状增强。GTN和非GTN病灶与正常肌层的时间-强度曲线各参数比较均差异有统计学意义(P<0.05),即病灶具有早增强、达峰时间早、增强速率块、峰值强度高等特点。与金标准比较,常规超声和超声造影诊断良恶性妊娠相关子宫疾病的符合率分别为82.93%(34/41)、92.68%(38/41)。结论:超声造影增强特征有助于鉴别妊娠相关子宫病灶良恶性,为临床治疗提供准确信息,有重要临床应用价值。
Objective： To investigate the diagnostic value of contrast-enhanced ultrasound （CEUS） in gestational trophoblastic neoplasia （GTN）. Methods： Thirty-seven cases with 41 suspicious GTNs were reviewed, which were examined by conventional ultrasound and CEUS from August 2015 to July 2016 in West China Second University Hospital, Sichuan University. Malignant masses were enrolled in GTN group including 30 cases with 34 masses and benign masses were enrolled in non-GTN group including 7 cases with 7 masses. All the masses were confirmed by ＂gold standard＂ （pathological results and clinical cure）. Results： The enhancement patterns of GTNs： 44.12% （15/34） showed regional enhancement, 29.41% （10/34） showed diffuse enhancement. The enhancement patterns of non-GTNs： 5 cases with pregnancy residues showed regional enhancement, 2 cases with mass-type uterine ectopic pregnancy showed ring-like enhancement. There were significant differences in the parameters of time- intensity curve between GTNs or non-GTNs and normal muscle layer （P〈0.05）. All lesions showed earlier initial time and peak time, greater enhancement rate and higher peak intensity than the normal muscle layer. Compared with the ＂gold standard＂, the coincidence rates of ultrasound and CEUS in the diagnosis of benign or malignant pregnaricy-associated uterine diseases were 82.93% （34/41） and 92.68% （38/41）, respectively. Conclusion： The CEUS features of benign and malignant pregnancy-associated uterine diseases were different, which are helpful in the differential diagnosis. In addition, CEUS provides more accurate information and application value.
作者
严霞瑜
罗红
杨帆
田甜
YAN Xiayu LUO Hong YANG Fan TIAN Tian(Department of Diagnostic Ultrasound, West China Second University Hospital, Sichuan University, Key Laboratory of Obstetric ＆ Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610041, Sichuan Province, China)
出处
《肿瘤影像学》
2017年第3期177-182,共6页
Oncoradiology
基金
四川省科技厅应用基础研究支撑项目(No:2012JY0083)
关键词
常规超声
超声造影
妊娠滋养细胞肿瘤
Conventional ultrasonography
Contrast-enhanced ultrasonography
Gestational trophoblastic neoplasia
