超声造影时间-强度曲线参数评估膀胱癌分期的研究

doi:10.7517/issn.1674-0475.210905

摘要/Abstract

摘要： 本次研究的目的是探讨超声造影在膀胱癌患者术前分期中的应用价值。选取膀胱癌患者90例,给予超声造影检查,比较超声造影与术后病理结果。超声造影术前T分期与术后病理Kappa值为0.699(P<0.05),诊断准确率为76.67%;超声造影术前N分期与术后病理Kappa值为0.705(P<0.05),诊断准确率为84.40%;低级别膀胱癌半洗漱时间(TPH)明显低于高级别膀胱癌(P<0.05),而半降支斜率(DS)明显高于高级别膀胱癌(P<0.05);TPH、DS鉴别低级别膀胱癌的ROC曲线下面积分别为0.766和0.709(P<0.05);TPH、DS鉴别低级别膀胱癌的灵敏性分别为72.90%和62.50%,特异性分别为71.40%和76.20%。超声造影在膀胱癌术前评估中有较好的应用价值。

关键词: 超声造影, 时间-强度曲线, 膀胱癌, 术前评估

Abstract: The purpose of this study was to discussed the value of contrast-enhanced ultrasound (CEUS) in preoperative staging of ladder cancer. A total of 90 patients with bladder cancer treated were selected for contrast-enhanced ultrasonography and compared with the postoperative pathological results. The Kappa value of preoperative T-stage of contrast-enhanced ultrasound and postoperative pathological results was 0.699 (P<0.05), and the diagnostic accuracy was 76.67%. The Kappa value of preoperative N-stage of contrast-enhanced ultrasound and postoperative pathological results was 0.705 (P<0.05), and the diagnostic accuracy was 84.40%. The time from peak to one half (TPH) of low-grade bladder cancer was significantly lower than that of higher-grade bladder cancer (P<0.05), and the semi-descending slope (DS) was significantly higher than that of higher-grade bladder cancer (P<0.05). The area under ROC curve of TPH and DS for the differentiation of low-grade bladder cancer were 0.766 and 0.709 (P<0.05). The sensitivity of TPH and DS were 72.90% and 62.50%, and the specificity were 71.40% and 76.20%, respectively. Contrast-enhanced ultrasound has a good application value in preoperative evaluation of bladder cancer.

Key words: contrast-enhanced ultrasound, time intensity curve, bladder cancer, preoperative evaluation

陈雨娜, 周玫娟, 范娜. 超声造影时间-强度曲线参数评估膀胱癌分期的研究[J]. 影像科学与光化学, 2022, 40(2): 439-442.

CHEN Yuna, ZHOU Meijuan, FAN Na. Study on the Time-intensity Curve Parameters of Contrast-enhanced Ultrasound in Evaluating the Preoperative Staging of Bladder Cancer[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(2): 439-442.

参考文献

[1] 韩苏军,张思维,陈万青,等. 中国膀胱癌发病现状及流行趋势分析[J]. 癌症进展,2013,11(1):89-95.
[2] 孙凤岭,臧桐. 膀胱癌恶性程度及预后的分子标志[J]. 国外医学(泌尿系统分册),2000,20(4):158-159.
[3] 陈运贵. 多层螺旋CT三期增强扫描对膀胱癌的诊断价值研究[J]. 中国CT和MRI杂志,2019,17(3):102-104.
[4] 王萍,刘健,岳文胜,等. 超声造影与CT对膀胱癌术前分期的诊断价值比较[J]. 山东医药,2018,58(14):72-74.
[5] 徐盼,周爱云,袁新春,等. 超声造影时间-强度曲线鉴别高级别与低级别膀胱尿路上皮癌[J]. 中国医学影像技术,2015,31(2):282-285.
[6] Sobin D H,Witteking C H. TNM classification of malignant tumours[M]. 6th ed. New York:Wiley-liss,2002:199-202.
[7] Lerner S P. Innovations in endoscopic imaging for bladder cancer[J]. European Urology,2009,56(6):920-922.
[8] Cauberg E C C,Kloen S,Visser M,et al. Narrow band imaging cystoscopy improves the detection of non-muscle-invasive bladder cancer[J]. Urology,2010,76(3):658-663.
[9] Ding C,Wu K J,Wang W Y,et al. Synthesis of a cell penetrating peptide modified superparamagnetic iron oxide and MRI detection of bladder cancer[J]. Oncotarget,2017,8(3):4718-4729.
[10] Wu L M,Chen X X,Xu J R,et al. Clinical value of T2-weighted imaging combined with diffusion-weighted imaging in preoperative T staging of urinary bladder cancer[J]. Academic Radiology,2013,20(8):939-946.
[11] Olson M C,Abel E J,Mankowski Gettle L. Contrast-enhanced ultrasound in renal imaging and intervention[J]. Current Urology Reports,2019,20(11):1-8.
[12] 姚晓松,陈菲,许晓辉,等. 超声造影与螺旋计算机断层扫描对膀胱癌术前分期诊断价值的比较分析[J]. 肿瘤基础与临床,2019,32(2):170-172.
[13] Zhu W,Mai G,Zhou X,et al. Double contrast-enhanced ultrasound improves the detection and localization of occult lesions in the pancreatic tail:A initial experience report[J]. Abdominal Radiology,2019,44(2):559-567.
[14] Cao J Y,Dong Y,Fan P L,et al. Feasibility of dynamic three-dimensional contrast-enhanced ultrasound in focal liver lesions:Image quality evaluation and correlation of quantification with two-dimensional contrast-enhanced ultrasound[J]. Clinical Hemorheology and Microcirculation,2019,72(3):305-316.
[15] Wu J F,Wu C,Wang Y L,et al. Diagnostic accuracy of contrast-enhanced ultrasound in the detection of small renal masses:A protocol of systematic review and meta-analysis[J]. Medicine,2020,99(29):e21262.
[16] 陈信义,徐力,张燕明,等. 恶性肿瘤新生血管研究进展[J]. 癌症进展,2005,3(6):528-533.
[17] 高白,姚胜银,王嫦华,等. MSCT增强扫描与超声造影对膀胱癌术前分期的诊断价值[J]. 中国CT和MRI杂志,2019,17(4):105-108.
[18] 杨国庆. 膀胱癌的超声造影时间-强度曲线参数与癌细胞侵袭性生长、病灶内血管新生的相关性[J]. 海南医学院学报,2018,24(9):975-978.