良恶性子宫内膜病变的超声造影特点及鉴别诊断价值分析  

Image characteristics of contrast-enhanced ultrasonography and diagnostic value in differentiating benign and malignant endometrial lesions

作　　者：张娟 袁建军 朱好辉 武莉娜 董卫红 王睿丽 Zhang Juan;Yuan Jianjun;Zhu Haohui;Wu Lina;Dong Weihong;Wang Ruili(Department of Ultrasonography,Henan Provincial People′s Hospital,Zhengzhou University People′s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院超声科,郑州大学人民医院,郑州450003

出　　处：《中华全科医师杂志》2024年第5期499-503,共5页Chinese Journal of General Practitioners

基　　金：河南省医学科技攻关计划项目(LHGJ202000432021)。

摘　　要：选取河南省人民医院2020年5月至2023年5月疑似子宫内膜病变患者62例,所有患者均进行子宫超声造影技术检查与病理活检,以病理活检作为金标准确定超声造影检查的准确率。超声造影观察子宫内膜病变部位,以同一患者子宫肌层为参照,观察超声造影良恶性子宫内膜病变情况的影像学特征、结合时间-强度曲线定量参数,并结合内膜厚度及动脉阻力指数,分析超声造影以及时间-强度曲线定量参数对子宫内膜病变良恶性的鉴别诊断价值。结果显示超声造影检查子宫内膜病变良恶性准确率为96.77%(60/62),60例患者中良性病变35例,恶性病变25例。良性组峰值强度、曲线下面积均低于恶性组,而达峰时间、始增时间及峰值减半时间均高于恶性组,差异有统计学意义(P<0.05);峰值强度、达峰时间、曲线下面积、始增时间均为子宫内膜病变良恶性的鉴别诊断价值指标,其中达峰时间的诊断价值最高(灵敏度0.905,特异度0.912)。提示超声造影在良恶性子宫内膜疾病诊断中具有一定的价值,可通过超声造影特点并结合时间-强度曲线提供参考。Sixty two patients with suspected endometrial lesions who underwent contrast-enhanced ultrasonography(CEUS)examination and pathological biopsy in Henan Provincial People′s Hospital from May 2020 to May 2023 were enrolled.The imaging characteristics,quantitative parameters of time-intensity curve,endometrial thickness and arterial resistance index of benign and malignant endometrial lesions were analyzed.Using pathological biopsy as the gold standard,the accuracy of CEUS examination in differentiating benign and malignant endometrial lesions was evaluated.The CEUS results were consistent to pathological examination in 60 cases(35 benign lesions and 25 malignant lesions)with an accuracy rate of 96.77%(60/62).The peak intensity and area under curve in benign group were lower than those in malignant group,but the peak time,onset time and peak halving time were higher than those in malignant group(P<0.05).Among above indicators,peak time had the highest value in differential diagnosis of benign and malignant lesions with a sensitivity of 0.905 and specificity of 0.912.The study suggests that contrast-enhanced ultrasound has a certain diagnostic value in differentiating benign and malignant endometrial diseases.

关 键 词：超声造影 子宫内膜病变 病理活检 图像特点 诊断 

分 类 号：R737.33[医药卫生—肿瘤] R445.1[医药卫生—临床医学]