老年女性子宫内膜良恶性病变超声特征分析及诊断模型预测  

Ultrasound characteristics and diagnostic model prediction of benign and malignant endometrial lesions in elderly women

作　　者：王立淑[1] 于腾飞[1] 杨保军[2] 宋海曼[1] 刘影[1] 何文[1] Wang Lishu;Yu Tengfei;Yang Baojun;Song Haiman;Liu Ying;He Wen(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Obstetrics and Gynecology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100070 [2]首都医科大学附属北京天坛医院妇产科,北京100070

出　　处：《中华老年医学杂志》2022年第7期822-826,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨绝经后老年女性子宫内膜良恶性病变的超声特征。方法选取2019年1月至2021年11月在首都医科大学附属北京天坛医院行经阴道超声检查的子宫内膜病变患者,以患者手术后的病理诊断为金标准,根据手术病理结果将内膜病变分为良性病变组(包括子宫内膜增生及子宫内膜息肉)及恶性病变组(子宫内膜癌),比较良性组与恶性组子宫内膜厚度、多普勒血流参数,以及良性组与恶性组回声均匀性、是否合并囊性结构、子宫内膜-肌层交界完整性、血流评分及供血血管的差异,并根据上述超声特征建立预测模型。结果共有136例患者在我院手术并有明确的病理结果,其中良性病变组72例,恶性病变组64例。恶性病变组收缩期峰值流速(PSV)、舒张末期流速(EDV)高于良性病变组[(28.75±14.66)cm/s比(22.94±13.62)cm/s、(14.75±8.10)cm/s比(11.56±6.21)cm/s],恶性病变组病变厚径显著大于良性病变组[(19.31±8.97)mm比(10.14±4.31)mm],血流阻力指数低于良性病变组(14.75±8.10比11.56±6.21),差异均有统计学意义(t=2.393、2.597、7.452、2.028,均P<0.05)。根据上述超声特征建立预测模型,超声医师诊断内膜良恶性病变的ROC曲线下面积为0.905(P<0.001),该预测模型具有较高的诊断价值。结论绝经后老年女性子宫内膜良性病变及恶性病变均有不同的超声特征,恶性病变倾向于更厚的病变厚度、子宫内膜-肌层交界中断或不规则、血流信号评分更高及多支供血血管的血供模式,超声预测模型在诊断良恶性内膜病变中具有较高的诊断价值。Objective To investigate the ultrasound characteristics of benign and malignant endometrial lesions in postmenopausal women terminology.Methods Patients with endometrial lesions who underwent transvaginal ultrasound examination in Beijing Tiantan Hospital affiliated to Capital Medical University from January 2019 to November 2021 were selected.Pathological diagnosis after surgery was used as the gold standard,and endometrial lesions were divided into a benign group(including endometrial hyperplasia and endometrial polyps)and a malignant group(endometrial cancer)according to surgical pathology results.Endometrial thickness and Doppler flow parameters were compared between the benign group and the malignant group.The chi-square test was used to compare the echogenicity,the presence or absence of cystic areas,the integrity of the endometrial-myometrial junction,the blood flow score,and the blood supply vessels between the benign and malignant groups.A prediction model was established according to the ultrasonic characteristics.Results A total of 136 participants received surgery at our hospital with definitive pathological diagnoses,including 72 patients in the benign group and 64 patients in the malignant group.Peak systolic velocity(PSV)and end diastolic velocity(EDV)in malignant lesions were higher than those in benign lesions[(28.75±14.66)cm/s vs.(22.94±13.62)cm/s,(14.75±8.10)cm/s vs.(11.56±6.21)cm/s].The thickness of malignant lesions was significantly greater than that of benign lesions[(19.31±8.97)mm vs.10.14±4.31)mm],and the blood flow resistance index was lower than that of benign lesions(14.75±8.10 vs.11.56±6.21).The differences were statistically significant(t=2.393,2.597,7.452,2.028,all P<0.05).The prediction model was established based on the above ultrasonic characteristics.The area under the ROC curve for ultrasound physicians to diagnose benign and malignant endometrial lesions was 0.905(P<0.001),indicating that the prediction model had high diagnostic value.Conclusions Both benign and malign

关 键 词：子宫内膜肿瘤 超声检查 

分 类 号：R737.33[医药卫生—肿瘤]