Application Value Of Real-time Shear Wave Elastography In Diagnosing Depth Of Invasion Myometrium Of Endometrial Cancer

Objective:To explore the clinical application value of real-time shear wave elastography in diagnosing the depth of invasion myometrium by endometrial cancer.Method:71 patients with stage I myometrial invasion by endometrial cancer confirmed by pathology and 37 normal people who had been chosen in the Fourth Hospital of Hebei Medical University from May 2019 to January 2020 were divided into 3 groups.The grouping is as follows: Group A:57 cases were shallow muscle invasion of endometrial cancer.Patients in this group were those with stage ? endometrial cancer with less than half myometrial invasion.Group B:14 cases were deep muscle invasion of endometrial cancer.Patients in this group were those with stage?endometrial cancer invasion equal to or more than half of the myometrium.Group C:40 cases with normal physical examination were the control group.After every patient performing two-dimensional ultrasound,then switch to the real-time shear wave elastography mode,and measure Emax?Emean and Esd of shallow and deep myometrium of the three groups,finally performed statistical analysis.Results:1.Comparison of the elastic modulus between the near intimal surface myometrium and the near serosal surface myometrium in the control group:the results were all P>0.05 and the differences were not statistically significant.2.Compared with Emax and Emean between the invasing myometrium and the non-invasing myometrium in shallow muscle invasion of endometrial cancer,the results were P<0.05 and the differences were statistically significant;Compared with Esd,the results were P>0.05 and the differences were not statistically significant.3.Comparison of the elastic modulus between myometrium of the deep muscle infiltration of endometrial cancer and the control group: the results were P<0.05 and the differences were statistically significant.4.The area under ROC curve by Emax and Emean of invasing myometrium and non-invasing myometrium in shallow muscle invasion of endometrial cancer were 0.82 and 0.85,and the best truncations were 32.22 k Pa and 27.54 k Pa.With the truncation of Emax to diagnose invasing myometrium,the diagnostic sensitivity was 82.5%,the specificity was 75.4%,the positive predictive value was 77.0%,and the negative predictive value was 81.1% and the accuracy was 78.9%.With the truncation of Emean to diagnose invasing myometrium,the diagnostic sensitivity was 82.5%,the specificity was 82.5%,the positive predictive value was 82.5%,and the negative predictive value was 82.5% and the accuracy was 82.5%.5.With Emax ? 32.22 k Pa or Emean ? 27.54 k Pa as the ultrasound standard to diagnose invasing myometrium.Compared with the pathological gold standard,the coincidence rate of real-time shear wave elastography for deep myometrial invasion of endometrial cancer was 92.9%.6.The area under ROC curve by Emax?Emean and Esd of myometrium of the deep muscle infiltration of endometrial cancer and the control group were 0.98?0.95 and 0.88,and the best truncations were 39.03 k Pa?28.17 k Pa and 3.28 k Pa.With the truncation of Emax to diagnose invasing myometrium,the diagnostic sensitivity was 92.9%,the specificity was 97.3%,the positive predictive value was 92.9%,and the negative predictive value was 97.3% and the accuracy was 96.1%.With the truncation of Emean to diagnose invasing myometrium,the diagnostic sensitivity was 92.9%,the specificity was 94.6%,the positive predictive value was 86.7%,and the negative predictive value was 97.2% and the accuracy was 94.1%.With the truncation of Esd to diagnose invasing myometrium,the diagnostic sensitivity was 92.9%,the specificity was 83.8%,the positive predictive value was 68.4%,and the negative predictive value was96.9% and the accuracy was 86.3%.Conclusions: Real-time shear wave elastography is helpful to determine the depth of infiltrating myometrium of endometrial cancer,and has important guiding value for formulating surgical schemes and judging prognosis.