超声造影对子宫内膜病变良恶性鉴别诊断价值的研究  

The Value of Real-Time Contrast-Enhanced Ultrasound in the Diagnosis of Endometrial Lesions

作　　者：车德红[1] 周显礼[1] 韦虹[1] 张艳华[1] 麻世红[1] 

机构地区：[1]哈尔滨医科大学附属第二医院,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2013年第34期6696-6699,6780,共5页Progress in Modern Biomedicine

基　　金：黑龙江省科技计划项目(GB05C402-08);哈尔滨医科大学附属第二医院院青年基金(QN2010-07);黑龙江省卫生厅科研课题(2010-047)

摘　　要：目的:探讨超声造影检查子宫内膜病变灌注特征及其在子宫内膜良恶性疾病中的鉴别诊断价值。方法:选择50例经阴式或腹式超声检查发现子宫内膜病变的术前患者。造影剂选用SonoVue,剂量为2.4 mL,以团注方式由肘部浅静脉注入进行实时超声造影检查,观察宫腔内病变和子宫肌层、子宫内膜造影剂的显影特征及增强方式等超声造影表现,绘制时间-强度曲线(TIC),与病理结果对照并分析各病灶的造影剂灌注特征,比较良、恶性病变的曲线参数的差别。结果:50例子宫内膜病变患者,29例良性病变和21例恶性病变。19例子宫内膜良性病变造影剂多同时或晚于子宫肌层增强,增强均匀,廓清晚于子宫肌层或同步于肌层。16例子宫内膜癌病变增强迅速,呈整体强化,病变区造影剂廓清,出现早于肌层,表现为"快进快出"。通过对时间-强度曲线的分析得出,良性病变与恶性病变平均绝对峰值强度、上升时间和斜率差别有统计学意义。结论:子宫内膜病变不同超声造影灌注模式特征和时间-强度曲线(TIC)不同,并对其良恶性鉴别诊断有重要意义。Objective： To investigate the characteristics of ultrasound perfiasion in endometrial lesions, and to evaluate its differential diagnosis in malignant and benign endometrial lesions. Methods： 50 preoperative patients with endometrial lesions were selected to per- form the contrast-enhanced ultrasound imaging with SonoVue, which was injected intravenously as a bolus in （2.4） ml. Real time contrast enhanced ultrasound was performed to observe the enhanced pattern and characteristics. The ROI （regions of interest）were chosen on the enhancement parts in the endometrial lesions and myometrium in order to obtain the TIC （timed-intensity curves）. The kinetic parameters of TIC were compared between benign and malignant endometrial lesions according to pathology. Results： 21 cases were malignant and 29 cases were benign among 50 patients. 16 cases of endometrial benign lesions were enhanced later than the myometrium or the same time with the myometrium, which were washed-out later than the uninvolved myometrium. 19 cases of the endometrial carcinoma were enhanced earlier than the uninvolved myometrium, which were washed-out in advance of myometrium. Absolute peak intensity, average uptake time and ascending slope rate of endometrial carcinomas and endometrial benign lesions is different significantly. Conclusions： Different enhancement patterns were observed in endometrial lesions respectively. Contrast-enhanced Ultrasound can be applied to dif- ferentiate between benign and malignant endometrial lesions.

关 键 词：超声造影 子宫内膜病变 时间-强度曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.7[医药卫生—诊断学]