经阴道超声联合超声弹性成像在子宫肌瘤诊断中的应用价值  

Application value of transvaginal ultrasound combined with ultrasound elastography in the diagnosis of uterine fibroids

作　　者：耿喆 GENG Zhe(Department of Ultrasound Interventions,Zhejiang Rongjun Hospital,Jiaxing,Zhejiang 314001,China)

机构地区：[1]浙江省荣军医院超声介入科,浙江嘉兴314001

出　　处：《中国妇幼保健》2023年第11期2108-2112,共5页Maternal and Child Health Care of China

基　　金：浙江省嘉兴市科技计划项目(2019AY32014)。

摘　　要：目的探究经阴道超声联合超声弹性成像在子宫肌瘤诊断中的应用价值。方法选取2019年1月—2022年1月浙江省荣军医院收治的80例子宫肌瘤患者为观察组,同期在该院体检的76例健康体检者为对照组,回顾性分析两组研究对象临床资料,所有受检者均接受阴道超声和超声弹性成像检查,以组织病理学检查为“金标准”,评估阴道超声、超声弹性成像及联合检查诊断子宫肌瘤的准确率、灵敏度及特异度。结果阴道超声提示子宫肌瘤患者子宫体积增大,轮廓改变,局部存在结节状突起;肌瘤呈圆形、扁圆形或不规则形状,回声不均匀,以低回声为主,同时可见等回声;肌瘤与肌层间分界明显,血流以环状血流为主,部分可见半环状血流。超声弹性成像显示正常子宫肌层以蓝色、蓝绿相间为主,肌瘤边界清晰,肌瘤内部大部分为蓝色阴影,部分可见蓝绿相间;肌瘤包膜清晰,局部或全部显示为红色或黄绿色。观察组患者子宫动脉血流阻力指数平均为(0.52±0.04),SR值为(1.52±0.71)。对照组血流阻力指数平均为(0.98±0.21)。两组研究对象血流阻力指数比较,差异有统计学意义(t=19.232,P<0.05)。以组织病理学检查为“金标准”,阴道超声检出子宫肌瘤75例,超声弹性成像检出子宫肌瘤76例,联合检测检出子宫肌瘤79例。不同检查方法诊断的灵敏度、阳性预测率、阴性预测率及准确率比较,差异均有统计学意义(均P<0.05),且阴道超声联合超声弹性成像检查诊断子宫肌瘤的灵敏度、阳性预测率、阴性预测率及准确率均高于阴道超声检查和超声弹性成像检查(均P<0.05),联合检测诊断壁间子宫肌瘤、阔韧带子宫肌瘤的准确率明显高于阴道超声检查和超声弹性成像检查(均P<0.05)。结论经阴道超声、超声弹性成像在诊断子宫肌瘤中均有一定效果,二者联合诊断可进一步提高子宫肌瘤的诊断灵敏度和准确率。Objective To explore the application value of transvaginal ultrasound and ultrasound elastography in the diagnosis of uterine fibroids.Methods From January 2019 to January 2022,80 cases of the Zhejiang Rongjun Hospital were the control group,in the same period,76 healthy subjects in the hospital were the control group,the clinical data of the two groups were analyzed.All subjects received vaginal ultrasound and ultrasound elastography,taking histopathological examination as the"gold standard"to evaluate the accuracy,sensitivity and specificity of vaginal ultrasound,ultrasound elastography and combined examination for the diagnosis of uterine fibroids.ResultsVaginal ultrasound indicates that the uterine size increases,contour changes,and local tuberous protrusion;the fibroids are round,oblate or irregular shape,uneven echo,mainly hypoecho,and visible echo;fibroids and myometrial,mainly annular blood flow,and partial visible half annular blood flow.Ultrasound elastography showed that normal myometrium was mainly blue,blue and green,with clear boundaries,most of the fibroids were blue shadows,and some blue and green;the capsule was clear,locally or all,red or yellow;the observation group(0.52±0.04)and SR value(1.52±0.71).The mean flow resistance index in the control group was(0.98±0.21):The difference between the two groups in blood flow resistance index was significant(t=19.232,P<0.05).With histopathological examination as the"gold standard",75 cases of uterine fibroids were detected by transvaginal ultrasound,76 cases by ultrasound elastography,and 79 cases by combined testing.Comparing the sensitivity,positive prediction rate,negative prediction rate and accuracy of different examination methods,the differences were statistically significant(all P<0.05).The sensitivity of vaginal ultrasound combined with ultrasound elastography,positive prediction rate,negative prediction rate and accuracy were high dry vaginal ultrasound and ultrasound elastography(all P<0.05).The accuracy of interamural uterine fibroids and

关 键 词：子宫肌瘤 阴道超声 超声弹性成像技术 

分 类 号：R711.74[医药卫生—妇产科学]