子宫静脉内平滑肌瘤病的超声诊断价值  

Diagnostic Value of Ultrasound in Uterine Intravenous Leiomyomatosis

作　　者：胡麦果 张君[1] 钟晓红 郑晨晗 Hu Maiguo;Zhang Jun;Zhong Xiaohong;Zheng Chenhan(Department of Ultrasound,Women's and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital),Xiamen,Fujian 361005,China)

机构地区：[1]厦门大学附属妇女儿童医院(厦门市妇幼保健院)超声医学科,福建省厦门市361005

出　　处：《中国超声医学杂志》2024年第6期698-701,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨子宫静脉内平滑肌瘤病(IVL)的超声声像图特征,以提高对该病的超声诊断水平。方法 收集18例经组织病理学证实的IVL患者的临床和超声声像图特征。18例患者均行常规超声(CU)和超声造影(CEUS)检查。总结IVL的常规超声与CEUS的声像图特征。结果 18例IVL患者CU诊断的检出准确度和误诊率分别为55.6%(10/18)和44.4%(8/18),CU联合CEUS准确度和误诊率分别为88.9%(16/18)和11.1%(2/18);CU与CU联合CEUS检测结果间的差异有统计学意义(P<0.05)。在病灶内部血流显示率方面,CEUS的模式下,18例(100%)IVL病变均发现微血流,而CU仅显示9例(50%)存在血流,两者差异有统计学意义(P<0.05)。CEUS特征:IVL增强早期团块呈晚增强、低增强、不均匀增强,由周边向中央不均匀增强;增强晚期早消退,部分等消退。CEUS还可以进一步确定病变起源和静脉内延伸的途径。结论 CU存在检查病灶内微血流方面的不足,CU联合CEUS检查可以提高IVL诊断的准确度。Objective To investigate the ultrasonographic characteristics of uterine intravenous leiomyomatosis(IVL)and improve the ultrasonic diagnosability in this disease.Methods The clinical and ultrasonographic features of 18 patients with IVL confirmed by histopathology were collected.Conventional ultrasound(CU)and contrast-enhanced ultrasound(CEUS)were performed in all 18 patients.The characteristics of IVL in CU and CEUS were summarized.Results The accuracy and misdiagnosis rate of CU in 18 IVL patients were 55.6%(10/18)and 44.4%(8/18)respectively,and the rates of CU combined with CEUS were 88.9%(16/18)and 11.1%(2/18)respectively.The difference between CU and CU combined with CEUS were significant(P<0.05).In display rate of internal blood flow,all cases(1o0%)showed microblood flow of lesions in CEUS,while only 9 cases(50%)showed blood flow in CU,the difference between CEUS and CU was statistically significant(P<0.05).The features of CEUS including:In the early phase of enhancement,the mass showed late enhancement,low enhancement,inhomogeneous enhance-ment,and inhomogeneous enhancement from peripheral to central.Early washout or partial washout was in late phase.CEUS could further determine the origin of the mass and the extension pathway in vein.Conclusions There are deficiency of CU in microblood flow detecting in the IVL.CU combined with CEUS can improve the diagnostic ac-curacy in IVL.

关 键 词：子宫 静脉内平滑肌瘤病 常规超声 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]