子宫腺肌症特征性声像图表现与病理严重程度的相关性分析  

Correlation of Ultrasonographic Findings and Severity of Adenomyosis

作　　者：井茹芳[1] 李春伶[1] 高永艳[1] 周红莉[2] 董继红[1] 

机构地区：[1]武警总医院南楼特诊科,北京市100039 [2]武警总医院保健科,北京市100039

出　　处：《中国超声医学杂志》2008年第4期352-354,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨子宫腺肌症特征性声像图表现与病理学疾病严重程度的相关性。方法58例经手术病理证实的子宫腺肌症患者,根据病理结果分为轻微型、局限型和严重型。超声研究的内容包括子宫是否增大、宫腔线是否偏移、是否合并有子宫肌瘤、是否存在子宫肌层弥漫性回声不均及RI和PI多普勒血流参数。结果58例中,21例轻微型,11例腺肌瘤型,26例重度型。合并子宫肌瘤的14例。三型比较子宫增大与否P=0.008(未合并肌瘤P=0.036),宫腔线位置偏移P=1.000(未合并肌瘤的P=0.023),子宫肌层回声弥漫不均P=0.000(未合并肌瘤的P=0.000)。以RI>0.70、PI>1.17为标准,三型比较RI值P=0.735,PI值P=0.511。结论声像图中子宫是否增大、宫腔线是否偏移及是否存在子宫肌层弥漫性回声不均能够判断子宫腺肌症的严重程度,多普勒阻力指数和搏动指数虽然对诊断有一定的帮助,不能够作为判断本病严重程度的因素,合并子宫肌瘤对子宫腺肌症严重程度的判断具有干扰性。Objective To assess whether specific sonographic characteristics are indicative of the adenomyosis severity. Methods Fifty-eight patients with adenomyosis were determined via hysterectomy for the extent of disease ： mild, focal, and severe. Ultrasonography was retrospectively analyzed in all patients including presence of an enlarged uterine, excursion of uterine cavity line, diffuse uterine myoma, hysteromyoma and Doppler RI and PI parameter abnormality. Results Twenty-one specimens revealed mild adenomyosis, 11 appeared focal disease and 26 showed severe disease. Fourteen specimens were complicated with hysteromyoma. Compared to 3 categoriced types, there were significant differences of uterine enlargement, P= 0. 008 （without hysteromyoma, P=0. 036）, excursion of the uterine cavity line, P=1. 000 （without hysteromyoma, P=0. 023）, diffuse heterogeneous echoes P=0. 000 （without hysteromyoma, P= 0. 000）. There was no significant difference via the comparison of the 3 categories in RI （P =0. 735） and PI （P = 0.511）. Conclusions Enlargement of uterine, excursion of uterine cavity line and a diffuse heterogeneous echoes on ultrsonography related to the severity of adenomyosis in our study. Doppler parameters of RI and PI may help diagnose adenomyosis but can not estimate the extent of the disease. Presence of uterine myoma may limit the ability for diagnosing the severity of adenomyosis.

关 键 词：超声 子宫腺肌症 多普勒 

分 类 号：R711.71[医药卫生—妇产科学]