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目的探究经阴道彩色多普勒超声(TVCDS)诊断宫颈癌及评估病灶内血管情况的临床价值。方法选取该院2014年9月-2016年3月期间确诊为宫颈癌的患者54例为观察组,另取54例同期体检的健康女性作对照组,回顾性分析其临床资料,比较两组患者TVCDS的声像图特点以及血流动力学改变与肿瘤的临床分期、组织学分类之间的关系。结果宫颈上皮内瘤变、宫颈原位癌以及宫颈癌I期患者中宫颈偏大的比例均与对照组差异无统计学意义(P>0.05),而宫颈癌Ⅱ期患者中宫颈偏大的比例明显高于对照组,差异有统计学意义(P<0.05)。宫颈上皮内瘤变患者中宫颈高回声的发生率明显高于对照组,宫颈原位癌、宫颈癌Ⅰ期及Ⅱ期患者中宫颈低回声的发生率明显高于对照组,差异均有统计学意义(P<0.05)。宫颈癌组+++级血流信号的比例和收缩期峰值血流速度(PSV)明显高于对照组,阻力指数(RI)明显低于对照组,差异有统计学意义(P<0.05);随着临床分期增加,PSV增加,RI降低,组间比较差异有统计学意义(P<0.05)。不同宫颈癌组织学类型的PSV及RI差异无统计学意义(P>0.05)。结论 TVCDS可通过检测宫颈大小、回声及血流动力学指标等情况为宫颈癌的诊断及分期提供理论依据,值得临床推广。
Objective To investigate the clinical value of transvaginal color Doppler ultrasonography (TVCDS) in the diagnosis of cervical cancer and assessment of intravascular lesions. Methods 54 cases diagnosed as cervical cancer from September 2014 to March 2016 in our hospital were selected as observation group and 54 healthy women in same period as control group. The clinical data were retrospectively analyzed. TVCDS sonographic features and the relationship between hemodynamic changes and clinical stage of the tumor, histological classification. Results Cervical intraepithelial neoplasia, cervical carcinoma in situ and cervical cancer in patients with stage I cervical proportion was not significantly different from the control group (P> 0.05), while cervical cancer in patients with large proportion of cervical The difference was statistically significant (P <0.05). The incidence of cervical hyperechoic in patients with cervical intraepithelial neoplasia was significantly higher than that in the control group. The incidence of cervical hypoechoic in patients with stage I and II cervical carcinoma, cervical cancer was significantly higher than that in the control group, the differences were statistically significant Significance (P <0.05). The ratio of + + grade blood flow signals and peak systolic velocity (PSV) in cervical cancer group were significantly higher than those in control group, and the resistance index (RI) was significantly lower than that in control group (P <0.05). As the clinical stage increased, PSV increased, RI decreased, there was significant difference between the two groups (P <0.05). There was no significant difference in the histological types of cervical cancer between PSV and RI (P> 0.05). Conclusion TVCDS can provide a theoretical basis for the diagnosis and staging of cervical cancer by detecting cervical size, echo and hemodynamic parameters, which is worthy of clinical promotion.