■目前,磁共振成像(MRI)是评估宫颈癌局部区域扩展的最常用的成像方法。正在研究对比增强超声(缩写为CEUS),作为MRI研究的替代或补充。
■与MRI相比,评估CEUS在识别宫颈癌局部浸润方面的性能,被认为是公认的参考标准。
■作为CEUS和MRI治疗前检查的一部分,对61例经组织病理学证实为宫颈癌的患者进行了调查。我们计算了CEUS与MRI对阴道肿瘤侵袭的准确性和一致性,膀胱,直肠,子宫旁,还有子宫.对于分析的时间-强度曲线相关参数(TTPK,AUC,峰值强度,冲洗和冲洗梯度)我们计算了灵敏度,特异性和阳性阈值,对于上述部位的肿瘤侵袭,具有ROC(接收器工作特性)曲线的图形表示。
■CEUS在检测膀胱方面具有很高的准确性(93.4%,95%CI:87.2-99.6)和子宫侵犯(88.5%,95%CI:80.5-96.5)。在子宫体(k=0.77,95%CI:0.56-0.98)和膀胱(k=0.56,95%CI:0.35-0.77)的侵袭方面,观察到CEUS和MRI之间的基本一致。局部区域入侵的ROC曲线分析显示,截止值为2.23的冲洗梯度在预测子宫入侵方面的敏感性为76%,特异性为67%。
■我们的结果表明,CEUS和MRI在子宫和膀胱侵犯方面具有很高的准确性和良好的一致性。这种成像方法可以帮助选择早期保留生育功能的手术患者,在怀疑早期膀胱侵犯的情况下也可使用。
UNASSIGNED: Currently, magnetic resonance imaging (MRI) is the most commonly used imaging method in the assessment of the loco-regional extension in cervical cancer. Contrast-enhanced ultrasound (abbreviated CEUS) is being investigated as an alternative or complement to the MRI investigation.
UNASSIGNED: To evaluate the performance of CEUS in identifying loco-regional invasion of cervical cancer compared to MRI, considered the accepted reference standard.
UNASSIGNED: Sixty-one patients with histopathologically confirmed cervical cancer were investigated as part of the pre-treatment workup by CEUS and MRI. We calculated the accuracy and concordance of CEUS versus MRI for tumor invasion in the vagina, bladder, rectum, parametrium, and uterus. For the time-intensity curve associated parameters analyzed (TTPK, AUC, peak intensity, wash in and wash out gradient) we calculated sensitivity, specificity and threshold value of positivity, for tumor invasion at the above-mentioned sites, with graphical representation of the ROC (receiver operating characteristic) curve.
UNASSIGNED: CEUS was highly accurate in detecting bladder (93.4%, 95% CI: 87.2-99.6) and uterine invasion (88.5%, 95% CI: 80.5-96.5). Substantial agreement between CEUS and MRI was observed for invasion in the uterine body (k=0.77, 95% CI: 0.56-0.98) and bladder (k=0.56, 95% CI: 0.35-0.77). ROC curve analysis for loco-regional invasions showed that the wash in gradient at a cut-off value of 2.23 had a sensitivity of 76% and a specificity of 67% in predicting uterine invasion.
UNASSIGNED: Our results demonstrate high accuracy and good agreement between CEUS and MRI regarding especially uterine and bladder invasion. This imaging method could help select patients in early stages for fertility sparing surgery, and also be of use in cases in which early bladder invasion is suspected.