IETA超声特征联合超低速血流成像对 子宫内膜癌的诊断价值

Diagnostic Value of IETA Ultrasound Features Combined with Slow Flow HD in Endometrial Cancer

摘要: 目的：探讨国际子宫内膜肿瘤分析(International Endometrial Tumor Analysis, IETA)超声特征简易评分法联合超低速血流成像(Slow Flow HD)对子宫内膜癌(Endometrial Cancer, EC)的诊断价值。方法：回顾性分析2023年8月至2025年7月于我院因不规则阴道流血就诊并接受治疗的65例患者临床资料，根据术后病理结果分为子宫内膜非癌变组(32例)和子宫内膜癌组(33例)。依据IETA共识对两组患者超声图像特征进行简易评分，计算各病例总分，并比较两组IETA评分及Slow Flow HD血流参数[血管指数(Vascular Index, VI)、血流指数(Flow Index, FI)]差异。采用二元Logistic回归建立联合诊断模型，并绘制受试者工作特征曲线(ROC)评价各方法诊断效能。结果：IETA简易评分中，子宫内膜非癌变组平均评分为7.88 ± 3.087，子宫内膜癌组为9.64 ± 2.177，差异具有统计学意义(P < 0.05)，其敏感性、特异性及AUC分别为84.8%、56.2%、0.707。与非癌变组相比，子宫内膜癌组VI、FI均升高(均P < 0.05)。ROC分析显示：VI的敏感性、特异性和AUC分别为81.8%、62.5%、0.728；FI分别为87.9%、43.7%、0.649 (均P < 0.05)。VI与FI联合时，敏感性、特异性和AUC分别为81.8%、59.4%、0.725，优于单一参数(P < 0.05)。当IETA评分联合VI、FI时，敏感性、特异性为97.0%、50.0%，AUC为0.732，诊断效能进一步提高(P < 0.05)。结论：IETA超声特征简易评分法联合Slow Flow HD血流参数可显著提高对子宫内膜癌的诊断效能，有助于早期识别高危患者。

Abstract: Objective: To investigate the diagnostic value of the simplified International Endometrial Tumor Analysis (IETA) ultrasound feature scoring system combined with Slow Flow HD in endometrial cancer (EC). Methods: The clinical data of 65 patients who presented with irregular vaginal bleeding and received treatment at our hospital from August 2023 to July 2025 were retrospectively analyzed. Based on postoperative pathological results, the patients were divided into a non-endometrial cancer group (32 cases) and an endometrial cancer group (33 cases). According to the IETA consensus, a simplified scoring of ultrasound image features was performed for both groups to calculate the total score for each case. The differences in IETA scores and Slow Flow HD blood flow parameters [Vascular Index (VI) and Flow Index (FI)] between the two groups were compared. A binary logistic regression was used to establish a combined diagnostic model, and receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic efficacy of each method. Results: In the simplified IETA scoring, the mean score of the non-endometrial cancer group was 7.88 ± 3.087, while the endometrial cancer group was 9.64 ± 2.177. The difference was statistically significant (P < 0.05), with a sensitivity, specificity, and area under the curve (AUC) of 84.8%, 56.2%, and 0.707, respectively. Compared with the non-cancerous group, both VI and FI were elevated in the endometrial cancer group (all P < 0.05). ROC analysis showed that the sensitivity, specificity, and AUC for VI were 81.8%, 62.5%, and 0.728, respectively; for FI, they were 87.9%, 43.7%, and 0.649, respectively (all P < 0.05). When VI and FI were combined, the sensitivity, specificity, and AUC were 81.8%, 59.4%, and 0.725, respectively, which was superior to that of a single parameter (P < 0.05). When the IETA score was combined with VI and FI, the sensitivity and specificity reached 97.0% and 50.0%, and the AUC was 0.732, indicating a further improved diagnostic efficacy (P < 0.05). Conclusion: The simplified IETA ultrasound feature scoring system combined with Slow Flow HD blood flow parameters can significantly improve the diagnostic efficacy for endometrial cancer, which is beneficial for the early identification of high-risk patients.