经阴道彩色多普勒超声对子宫内膜癌筛查及术前分期评估的作用  

Evaluative effect of TVCDS in screening and preoperative phasing endometrial carcinoma

作　　者：谢阳桂[1] 于秀[2] 张玉泉[3] 宋倩[5] 吕晓清[4] 章建国[4] 伏冰[5] 吴晨梅[3] 

机构地区：[1]南通大学附属医院医学超声科,226001 [2]南通大学附属医院普外实验室 [3]南通大学附属医院妇产科 [4]南通大学附属医院病理科 [5]南通大学硕士研究生

出　　处：《中华医学杂志》2010年第32期2250-2254,共5页National Medical Journal of China

基　　金：基金项目：南通市社会发展基金（S30026）

摘　　要：目的 探讨经阴道彩色多普勒超声（TVCDS）对子宫内膜癌筛查及术前分期评估的作用.方法 应用TVCDS筛查子宫内膜癌高危因素妇女713例,观察子宫内膜形态及病灶的部位、大小、回声、边缘是否规整,测量子宫内膜厚度,内膜与肌层交界面弱回声晕的完整性及病灶内血流,检测阻力指数（RI）,判断内膜癌及其肌层浸润程度.根据1988年国际妇产科联盟（FIGO）手术分期标准及磁共振成像（MRI）分期方法,将子宫内膜癌分为Ⅰ～Ⅳ期,并将TVCDS诊断与分期结果与手术病理对照.结果 在713例高危人群中TVCDS诊断子宫内膜癌100例,经手术病理证实的子宫内膜癌96例,TVCDS诊断和分期的符合率分别为96%（96/100）和94%（94/100）.结论 应用TVCDS诊断子宫内膜癌并能确切分期,为临床制定治疗方案、判断预后提供了可靠依据,具有临床应用价值.Objective To examine the evaluative effect of preoperative transvaginal color Doppler sonography （TVCDS） screening and phasing of endometrial carcinoma. Methods A total of 713jeopardized endometrial carcinoma patients were screened by TVCDS. The investigators observed the endometrium form, focus location, size and echo, measured the endometrium thickness, judged the regularity and integrity of edge, the integrity of faint echo halos at the interface between endometrium and muscularis and the blood flow inside focus, examined resistance index and determined endometrial carcinoma as well as muscularis infiltrating extent. According to the FIGO＇s phasing scheme in 1988, endometrial carcinoma was divided into Ⅰ , Ⅱ , Ⅲ and Ⅳ phases so as to compare the results of TVCDS in screening and phasing of endometrial carcinoma with that of operative pathology. Results One hundred cases were diagnosed as endometrial carcinoma. Among which, 96 were proved by surgical pathology as endometrial carcinoma. The rates of TVCDS screening and phasing coincidence were 96% （96/100） and 94% （94/100） respectively. Conclusion The application of TVCDS may diagnose and stage the cases of endometrial carcinoma. It is a valuable tool for selecting therapeutic regimens and making prognostic evaluations.

关 键 词：子宫内膜肿瘤 超声检查 多普勒 彩色 肿瘤分期 

分 类 号：R737.33[医药卫生—肿瘤]