| Objective: Through a comprehensive analysis of endometrial lesions by transvaginal 2D-CEUS and 3D-CEUS sonographic findings,and compared with the gold standard,to investigate the relationship between ultrasonographic signs and endometrial carcinoma,and discuss the establishment of ultrasonic scoring system in the diagnosis of endometrial carcinoma.Method: From January 2013 to December 2016 in the First Affiliated Hospital of Xinjiang Medical University gynecological ward in 203 cases of the patients with endometrial lesions(all 203 cases underwent transvaginal 2D-TVS,68 of which underwent transvaginal 2D-CEUS),with complete clinical and pathological data,ultrasound.1)68 suspected cases of endometrial lesions underwent prospective diagnostic tests,the transvaginal conventional ultrasound,transvaginal 2D and 3D-CEUS,to observe the ultrasonographic signs,screening identified endometrial benign and malignant lesions from the index,evaluate and compare their diagnostic value of endometrial lesions.2)Ultrasonographic features of endometrial lesions in transvaginal 2D-TVS and 2D-CEUS were analyzed retrospectively,and the diagnostic efficacy of the scoring system was evaluated by using ROC curve.Result: 1)In transvaginal 2D-CEUS,The perfusion phase of endometrial carcinoma was mainly early to enter and early to leave,65.4%(17/26),the intensity of enhancement was mainly enhanced by 76.9%(20/26),and the enhanced uniformity was mainly inhomogeneous(69.2%)(18/26),The endometrial lesions perfusion patterns statistically significant difference(P<0.05);There was statistical significance of TIC in benign and malignant endometrial lesions new contrast parameters(that is relative contrast parameters)?AT??TP??Peak ??RBF(P<0.05),ROC curve area of ?AT corresponds to the maximum(0.893),?AT =-840 ms was used as the cutoff value,the sensitivity(96.2%),specificity(88.1%),has high clinical value;2)3D-CEUS of endometrial benign and malignant lesions of sonographic features was statistically significant difference(P < 0.05);endometrial lesions 3D-CEPD vascular imaging parameters in benign and malignant group,with statistical significance the difference(P<0.05).3)transvaginal 2D-TVS?2D-CEUS and 3D-CEUS diagnosis of endometrial cancer myometrial invasion depth sensitivity,specificity,positive and negative likelihood ratio,positive predictive value,negative predictive value,accuracy and area under the ROC curve were 70.0%?68.9%?2.31?0.41?75.7%?64.5%?70.6%?0.646;77.8%?75.0%?3.11?0.29?87.5%?60.0%?76.9%?0.933;94.4%?100%?0?0.06?100%?88.9%?96.2%?0.972,respectively,The area under ROC curve of transvaginal 3D-CEUS(0.972)was the largest,and it had the highest diagnostic efficiency for myometrial invasion of endometrial carcinoma,transvaginal 3D-CEUS is most effective in the diagnosis of myometrial invasion in endometrial carcinoma;4)Ultrasonic scoring system for endometrial carcinoma on the basis of the OR value,the related references and the actual clinical experience established,through the ROC curve is divided into 7 selected diagnostic cut-off points,ROC curve for diagnosis of endometrial carcinoma was 0.917,the sensitivity(65.4%),specificity(97.6%),the score increased significantly the ultrasound diagnosis of endometrial carcinoma specificity.Conclusion: 1)transvaginal 2D-CEUS has a unique advantage in the diagnosis of endometrial carcinoma,new contrast parameters proposed in this study(i.e.relative contrast parameters)AT =-840 ms,because of its simple and easy measurement,high accuracy,easy generalization,is expected to become a new index of ultrasound diagnosis of endometrial carcinoma;2)transvaginal 3D-CEUS has great clinical value in the diagnosis of myometrial invasion of endometrial carcinoma;3)The proposed ultrasound scoring system for endometrial carcinoma improves the specificity of ultrasonography in diagnosing endometrial carcinoma(97.6%),and has preliminarily demonstrated the superiority of this scoring system in the diagnosis of endometrial carcinoma. |
PDF Full Text Request