常规超声与超声造影诊断盆腔结核对比分析  

Comparation of conventional ultrasound and contrast-enhanced ultrasound in diagnosis of pelvic tuberculosis

作　　者：熊希[1] 高春燕[1] 孙秋蕾[1] 颜苹[1] 

机构地区：[1]第三军医大学附属新桥医院妇产科,重庆400037

出　　处：《中国介入影像与治疗学》2015年第6期341-344,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的对比研究常规超声与CEUS对盆腔结核的诊断价值。方法回顾性对比分析42例临床病理诊断的盆腔结核患者的常规超声与CEUS与图像。结果常规超声诊断符合率42.86%(18/42),误诊率57.14%(24/42),CEUS诊断符合率66.67%(28/42),误诊率为33.33%(14/42),应用CEUS诊断盆腔结核的符合率高于常规超声(χ2=4.806,P=0.028)。常规超声显示15例表现为输卵管增大呈腊肠样改变,27例表现为以实性为主的混合回声病灶;病灶最大径(45.31±15.30)mm,CEUS显示15例表现为输卵管不均匀高增强,27例表现为以囊性为主的混合回声病灶,病灶中有多处较大的造影剂缺损区;病灶最大径(47.31±17.30)mm,与常规超声测得的病灶最大径差异无统计学意义(Z=0.289,P=0.773)。病灶实性部分造影剂上升时间平均为(10.24±2.55)s,子宫肌层增强时间为(14.52±3.11)s,差异有统计学意义(Z=3.990,P<0.001);病灶造影剂从峰值降至一半时间为(50.53±25.71)s,子宫肌层造影剂从峰值降至一半时间为(49.28±15.64)s,二者差异无统计学意义(Z=0.131,P=0.896)。结论 CEUS诊断盆腔结核的准确率高于常规超声。CEUS能客观的反映盆腔结核的血流灌注,提高盆腔结核的早期诊断率。Objective To compare the value of conventional ultrasound and CEUS in diagnosis of pelvic tuberculosis. Methods Forty-two patients with pelvic tuberculosis proved by laparoscopic were collected and the conventional ultrasound and CEUS imaging were analyzed retrospectively. Results The accuracy rate of the conventional ultrasound was 42.86% （18/42）, the misdiagnostie accuracy was 57.14% （24/42）, and the accuracy rate of the CEUS was 66.67% （28/42）, the misdiagnostic accuracy was 33.33 % （14/42）. The diagnostic accuracy of the CEUS was higher than that of the convention- al ultrasound in diagnosis of pelvic tuberculosis （X2= 4. 806, P=0. 028）. Totally 15 cases showed the fallopian tube swol- len was sausage-like changes, 27 cases showed mixed echo lesion mainly with solid echo on the conventional ultrasound ima- ges, the maximum diameter of the mass was （45.31±15.30）ram. And then 15 cases showed the fallopian tube was a high enhanced mode, 27 cases showed mixed echo lesion mainly with cystic echo, there were many large contrast defects in the lesion on CEUS images, the maximum diameter of the mass was （47.31± 17.30）ram, the difference of maximum diameter was not statistically significant （Z=0. 289, P=0. 773）. CEUS showed the arrival time （AT） of the solid lesion was （10.24±2.55）s, and the AT of myometrium was （14.52±3.11）s, the difference was statistically significant （Z=3. 990, P〈0. 001）. The half wash-out time （HWOT） of the lesion was （50. 53±25.71）s, and the HWOT of myometrium was （49.28±15.64）s, the difference was not statistically significant （Z=0. 131, P=0. 896）. Conclusion CEUS has a higher accuracy rate than that of the conventional ultrasound in dignosis of pelvic tuberculosis. The CEUS can reflect the blood perfusion of lesion objectively and can be used to improve the early accuracy rate for diagnosing the pelvic tuberculosis.

关 键 词：超声检查 超声造影 盆腔结核 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.33[医药卫生—诊断学]