三维超声自动测量技术对子宫内膜病变的诊断价值  

Diagnostic Value of Virtual Organ Computer-aided Analysis for Endometrial Disease

作　　者：刘红丽[1] 马丽丽[2] 刘萍[3] 代培凤[4] 

机构地区：[1]潍坊医学院妇产科学教研室,山东潍坊261053 [2]潍坊医学院附属潍坊市人民医院妇科 [3]潍坊市中医院妇科 [4]潍坊医学院附属潍坊市人民医院超声科

出　　处：《潍坊医学院学报》2010年第6期408-410,413,共4页Acta Academiae Medicinae Weifang

摘　　要：目的比较三维超声体积自动计算技术（VOCAL）测量子宫内膜体积与二维超声内膜厚度测量在诊断绝经后子宫内膜癌中的价值。方法收集98例绝经后阴道出血患者，用二维超声测量内膜厚度，三维超声下测量内膜体积。所有患者均经宫腔镜刮宫或手术病理证实，根据病理结果分为子宫内膜癌组、内膜良性增生组、正常萎缩内膜组。回顾性分析并比较内膜厚度与内膜相对体积在诊断绝经后子宫内膜出血性病变中的差异，并建立两种诊断方法的ROC曲线。结果内膜厚度与内膜相对体积在内膜癌组、内膜良性增生组及正常对照组分别为（1．57±0．65）cm、（30．97±10．45）％，（1．34±0．47）cm、（15．24±5．86）％，（0．36±0．21）cm、（4．75±5．26）％．内膜相对体积在3组之间均有显著性差异（P〈0.01），而内膜厚度在子宫内膜良恶性病变组之间无显著差异（P=0．03）。当以内膜厚度与内膜容积作为诊断指标时，ROC曲线下面积为分别为0．79，0．93。结论三维超声下VOCAI。测量子宫内膜相对体积较二维超声测量内膜厚度诊断绝经后子宫内膜癌为更加准确的诊断方法．Objective To compare the diagnostic value of measuring endometrial thickness using 2D-TVS and volume measurement hy VOCAL in patients with postmenopausal bleeding. Methods Ninety-eight patients with endometrial disease confirmed hy pathology were examined by 2D-TVS and 3D-TVS and the endometrial thiekness and volume measurements were measured respectively. According to the results of pathology, cases were classified into endometrial carcinoma, endometrial benign diseases anti nonnal endometrial group. The difference between the value of endometrial thickness and that of the volume measurements tot endometrial hemorrhagic disease was analyzed retrospectively. In order to evaluate the diagnostic value of endometrial volume anti endometrial thickness for endometrial carcinoma,the ROC curves were established. Results The mean volume of endometrium in women with atrophy, hyperplasia and carcinonm were（30.97±10. 45 ） c/c , （ 15.24± 5.86 ） % and （4.75 ± 5.26 ） % respectively. The mean thickness of endometrium in the three groups were （ 1.57±0. 65 ） cm, （ 1.34 ± 0.47 ） cm and（ 0.36± 0.21 ） cm respectively. There was significant difference in endometrial volume among the three groups （ P 〈0.01 ）. The difference was not significant in endometrial thickness between hyperplastic endometrium and endometrial carcinoma. The area under the volume curve was 0.93 ,while that of the endometrial thickness was 0.79. Conclusions Compared with endometrial thickness,endnmetrial volume measurement is more useful in the diagnosis of the endometrial carcinoma.

关 键 词：子宫内膜癌 三维超声体积自动测量技术(VOCAL) 内膜相对体积 ROC曲线 

分 类 号：R737.33[医药卫生—肿瘤]