超声诊断子宫内膜回声不均的临床价值分析  

Clinical Diagnostic Value of Ultrasonography in Diagnosis of Endometrial Echo Inhomogeneous

作　　者：王威[1] 张晓燕 卢珊[1] 种轶文[1] 张春妤[1] 郭红燕[1] Wang Wei;Zhang Xiaoyan;Lu Shan;Chong Yiwen;Zhang Chunyu;Guo Hongyan(Department of Gynecology and Obstetrics,Peking University Third Hospital,National Clinical Research Center for Obstetrics and Gynecology(Peking University Third Hospital),Key Laboratory of Assisted Reproduction(Peking University),Ministry of Education,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology,Beijing 100083,China;Department of Ultrasound,Beijing Dongcheng Maternal&Child Health Family Planning Service Centre,Beijing 10009,China)

机构地区：[1]北京大学第三医院妇产科,国家妇产疾病临床研究中心(北京大学第三医院),辅助生殖教育部重点实验室(北京大学),生殖内分泌与辅助生殖技术北京市重点实验室,北京市100083 [2]北京市东城区妇幼保健计划生育服务中心超声科,北京市100009

出　　处：《中国超声医学杂志》2022年第8期902-906,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨经阴道超声检查(TVUS)诊断子宫内膜回声不均的内膜病变的临床价值。方法 选择533例超声诊断子宫内膜回声不均的患者作为研究对象,结合年龄、超声检查及病理结果做回顾性分析。结果 以良性子宫内膜病变为主(84.99%,454/533),子宫内膜息肉357例(66.98%),子宫内膜炎42例(7.88%),黏膜下子宫肌瘤16例(3.0%),不伴细胞不典型子宫内膜增生39例(7.32%),不典型子宫内膜增生43例(8.07%),子宫内膜癌36例(6.75%)。良性子宫内膜病变高发于30~49岁(70.04%,318/454);不典型子宫内膜增生30~39岁(51.16%,22/43);≥40岁后子宫内膜癌占比显著增加(86.11%, 31/36)。结合血流信号及患者年龄分组,组间差异均具有统计学意义(P<0.05)。结合子宫内膜厚度分组,组间差异无统计学意义(P>0.05)。无序多分类Logistic回归分析显示,有血流信号,OR=3.433, 95%CI:1.646~7.161;≥50岁,OR=9.652, 95%CI:1.214~76.722。结论 血流信号和年龄≥50岁是子宫内膜癌的危险因素;子宫内膜回声不均结合患者年龄、彩色多普勒,为鉴别子宫内膜病变的良恶性提供重要依据,对早期子宫内膜癌的检出有重要意义。Objective To evaluate the clinical value of transvaginal ultrasonography in diagnosis of endometrial echo inhomogeneous for endometrial lesions. Methods This retrospective study had 533 cases of patients examined in Peking University Third Hospital with the ultrasonic diagnosis of endometrial echo inhomogeneous, which combined with the age of patients, the color Doppler flow imaging, all the cases were confirmed with pathological diagnosis. Results Most of the endometrial pathologies with the ultrasonic diagnosis of endometrial echo inhomogeneous were benign endometrial lesions(84.99%, 454/533), there were 357 endometrial polyps cases(66.98%), 42 endometritis cases(7.88%), 16 submucous myoma of uterus cases(3.0%), 39 endometrial hyperplasia without atypia cases(7.32%);42 atypical endometrial hyperplasia cases(8.07%), 36 endometrial cancer cases(6.75%). When the patient’s age between 30-49 years, the ratio of benign endometrial lesions was(70.04%, 318/454). When the patient’s age between 30-39 years, the ratio of atypical endometrial hyperplasia was highest(51.16%, 22/43). When the patient’s age ≥40 years, the ratio of endometrial cancer had a significant increase(86.11%, 31/36), The patients grouped by the color Doppler flow imaging and grouped by the age of patients all have significant statistical differences(P<0.05). The patients grouped by the endometrial thickness did not had significant statistical differences(P>0.05). Unordered mutlinomial logistic regression analysis showed that blood flow signal(OR=3.433, 95%CI: 1.646-7.161);age ≥50 years(OR=9.652, 95%CI: 1.214-76.722). Conclusions Blood flow signal and the patient’s age ≥50 year are the risk factors of endometrial cancer;combined with the patient’s age and CDFI, endometrial echo inhomogeneous can provided important basis for identify the benign or malignant lesions, especially for the detection of early endometrial cancer.

关 键 词：经阴道超声检查 子宫内膜回声不均 子宫内膜病变 彩色多普勒 年龄 病理诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.74[医药卫生—诊断学]