经阴道彩色多普勒超声对绝经后子宫内膜癌与息肉的诊断分析  

Analysis of transvaginal color Doppler ultrasound in the diagnosis of postmenopausal endometrial cancer and endometrial polyps

作　　者：王羽[1] 王建梅 WANG Yu;WANG Jianmei(Kailuan General Hospital of Tangshan City,Hebei Tangshan 063000,China)

机构地区：[1]河北省唐山市开滦总医院,河北唐山063000

出　　处：《中国妇幼健康研究》2022年第1期112-116,共5页Chinese Journal of Woman and Child Health Research

基　　金：河北省2019年度医学科学研究课题计划资助项目(20191328)。

摘　　要：目的探讨经阴道彩色多普勒超声对绝经后子宫内膜癌及子宫内膜息肉的诊断价值。方法回顾性分析2017年11月至2019年12月唐山市开滦总医院收治的30例绝经后子宫内膜癌患者(子宫内膜癌组)和99例绝经后子宫内膜息肉患者(子宫内膜息肉组)的经阴道彩色多普勒超声资料,对比二者经阴道彩色多普勒超声的声像图特征,并进行统计分析。结果子宫内膜癌组的子宫内膜病灶内部回声不均匀发生率和子宫内膜与邻近肌层分界不清晰发生率均显著高于子宫内膜息肉组,差异均有统计学意义(χ^(2)值分别为6.044、5.306,P<0.05)。子宫内膜癌组的子宫内膜厚度显著高于子宫内膜息肉组,而病灶血流阻力指数显著低于子宫内膜息肉组,差异均有统计学意义(t值分别为10.506、7.452,P<0.05)。子宫内膜癌组的病灶血流Ⅱ级+Ⅲ级占76.67%,明显高于子宫内膜息肉组的31.31%,差异有统计学意义(χ^(2)=6.918,P<0.05)。子宫内膜息肉组的平均血流速度(TAV)、搏动指数(PI)、子宫黏膜下肌瘤之间的动脉阻力指数(RI)均显著高于子宫内膜癌组,差异均有统计学意义(t值分别为6.665、8.389、26.653,P<0.05)。结论经阴道彩色多普勒超声对绝经后子宫内膜癌和子宫内膜息肉具有较好地鉴别诊断价值,值得推广应用。Objective To explore the value of vaginal color Doppler ultrasound in the diagnosis of endometrial cancer and endometrial polyps after menopause.Methods The imaging data of 30 postmenopausal endometrial cancer patients(endometrial cancer group) and 99 postmenopausal endometrial polyps patients(endometrial polyp group) admitted to Kailuan General Hospital of Tangshan city from November 2017 to December 2019 was analyzed retrospectively.The transvaginal color Doppler ultrasound imaging features of two groups were compared and analyze.Results The incidence of uneven internal echo of endometrial lesions and the incidence of unclear boundary between the endometrium and the adjacent muscle layer in the endometrial cancer group were significantly higher than those in the endometrial polyp group, and the differences were statistically significant(χ^(2)=6.044 and 5.306,respectively, P<0.05).The endometrial thickness of the endometrial cancer group was significantly higher than that of the endometrial polyp group, while the blood flow resistance index of the lesion was significantly lower than that of the endometrial polyp group.The differences were statistically significant(t=10.506,7.452,respectively, P<0.05).The blood flow of the lesions with grade Ⅱ and Ⅲ in the endometrial accounted for 76.67%,which was significantly higher than 31.31% in the endometrial polyp group, and the difference was statistically significant(χ^(2)=6.918,P<0.05).The time average velocity(TAV),pulsatility index(PI),and resistance index(RI) in the endometrial polyp group were higher than those in the endometrial cancer group, and the differences were statistically significant(t=6.665,8.389,and 26.653,respectively, P<0.05).Conclusion Transvaginal color Doppler ultrasound has a good differential diagnosis value for endometrial cancer and endometrial polyps after menopause, and it is worthy of popularization and application.

关 键 词：绝经 子宫内膜癌 子宫内膜息肉 经阴道彩色多普勒超声 血流阻力 

分 类 号：R737.3[医药卫生—肿瘤] R445.1[医药卫生—临床医学]