经阴道彩色多谱勒超声对子宫内膜癌肌层浸润深度的评估  

Measurement of the Depth of Myometrium Invasion by Endometrial Carcinoma with Transvaginal Ultrasonography

作　　者：蒋惠芬[1] 

机构地区：[1]建德市妇幼保健院,浙江建德311600

出　　处：《中国初级卫生保健》2011年第6期65-66,共2页Chinese Primary Health Care

摘　　要：目的探讨经阴道彩色多谱勒超声对子宫内膜癌肌层浸润深度及宫颈受累情况判断的准确性,为临床制订手术方案和判断预后提供依据。方法对本院经手术后病理诊断为子宫内膜癌的39例患者的声像图进行回顾性分析,总结子宫内膜癌的声像图特征、血流特点、阻力指数(RI值)、肌层浸润深度及宫颈受累情况,与术后病理检查结果对照,分别计算其准确率。结果 39例子宫内膜癌超声均见内膜有局限性或弥漫性增厚,回声不均,部分伴宫腔积液、子宫肌瘤及肌腺症等。超声肌层受浸判断准确率为82.05%,宫颈受累判断准确率为82.05%。子宫内膜癌血流显示率为84.61%(33/39),RI值为0.36～0.54,平均为0.45。结论经阴道彩色多谱勒超声能较客观地评价子宫体大小、内膜变化及血流动力学变化,并能清晰显示子宫内膜癌浸犯肌层及宫颈情况,为临床术前合理制订手术方案及判断预后提供重要依据。OBJECTIVES To investigate the role of transvaginal ultrasonography in the measurement of the depth of myometrium invasion by endometrial carcinoma and the evaluation of cervical involvement,thereby providing basis for the establishment of treatment strategy and prediction for the clinical outcome.METHODS The ultrasonographic images of 39 patients who were pathologically confirmed to have endometrial carcinoma were reviewed.The features of ultrasonographic images were summarized,as well as features of the blood flow and resistance index（RI）.The depth of myometrium invasion and the cervical involvement detected by ultrasound were compared with the results of postoperative pathological examination.The accuracy rates were calculated.RESULTS The ultrasonography revealed diffuse or local thickening of the endometrium in all of the 39 cases,with uneven echoes.Some of the cases had concomitant endometrial cavity fluid,leiomyoma and adenomyosis.The accuracy of the detection of myometrial involvement by ultrasound was 82.05%,and the detection of cervical involvement was 82.05%.The demonstration rate of blood flow in endometrial carcinoma was 84.61%（33/39）.The RI value ranged between 0.36 and 0.54,0.45 in average.CONCLUSION The transvaginal ultrasonography is able to accurately evaluate the size of the uterine,endometrial alterations and changes of hemodynamic,as well as the involvement of the myometrium and cervix.It,therefore,can provide important information for clinicians to establish a operation strategy and predict clinical outcomes.

关 键 词：经阴道彩色多谱勒超声 子宫内膜癌 浸润 

分 类 号：R714.22[医药卫生—妇产科学]