超声弹性成像技术对子宫平滑肌瘤、非典型平滑肌瘤及子宫平滑肌肉瘤的术前鉴别诊断价值  

The Preoperative Differential Diagnostic Value of Ultrasound Elastography in Uterine Leiomyomas,Atypical Leiomyomas,and Uterine Leiomyosarcomas

作　　者：张瑶瑶 钟龚乐 陈夏 叶思思 ZHANG Yaoyao;ZHONG Gongle;CHEN Xia;YE Sisi(Department of Gynecology,Dongguan Kanghua Hospital,Dongguan Guangdong 523000,China;Department of Medical,Dongguan Kanghua Hospital,Dongguan Guangdong 523000,China)

机构地区：[1]东莞康华医院妇科,广东东莞523000 [2]东莞康华医院医务部,广东东莞523000

出　　处：《临床研究》2024年第12期12-15,共4页Clinical Research

基　　金：2022年东莞市社会发展科技项目(20221800902502)。

摘　　要：目的研究超声弹性成像技术用于子宫平滑肌瘤、非典型平滑肌瘤及子宫平滑肌肉瘤的术前鉴别诊断价值。方法选取2022年9月至2023年10月东莞康华医院收治的200例疑似子宫平滑肌瘤患者作为研究对象,以手术病理结果为金标准,将患者分为A组(n=94,子宫平滑肌瘤)、B组(n=72,非典型平滑肌瘤)及C组(n=34,子宫平滑肌肉瘤)。比较不同病变患者超声弹性成像的特征和定量参数水平,采用Logistic多因素模型分析子宫平滑肌肉瘤病变的相关因素,采用受试者工作曲线(ROC)分析超声弹性成像参数在子宫平滑肌瘤、非典型平滑肌瘤及子宫平滑肌肉瘤中的鉴别诊断中的价值。结果C组Adler血流分级和弹性成像评分高于A、B两组,肿块边界清晰率、正常组织肌层与病变组织的应变率比值(SR)及阻力指数(RI)值均低于A、B两组,差异均有统计学意义(P<0.05)。Logistic多因素分析结果显示,边界、Adler分级及弹性成像评分是子宫平滑肌肉瘤的高危因素,差异均有统计学意义(P<0.05),SR与RI是子宫平滑肌肉瘤的保护因素,差异均有统计学意义(P<0.05)。受试者ROC分析显示,超声弹性成像参数联合鉴别诊断子宫平滑肌肉瘤的曲线下面积(AUC)为0.876,敏感度为0.917,特异度为0.560。结论超声弹性成像技术可为子宫平滑肌瘤病变性质的诊断提供定量分析参数,有助于子宫平滑肌肉瘤的鉴别诊断,具有较高临床应用价值。Objective To investigate the preoperative differential diagnostic value of ultrasound elastography in uterine leiomyomas,atypical leiomyomas,and uterine leiomyosarcomas.Methods A total of 200 patients suspected of having uterine leiomyomas who were treated at Dongguan Kanghua Hospital from September 2022 to October 2023 were included in the study.Based on surgical pathology results,patients were divided into three groups:Group A(n=94,uterine leiomyoma),Group B(n=72,atypical leiomyoma),and Group C(n=34,uterine leiomyosarcoma).The characteristics and quantitative parameters of ultrasound elastography were compared among the different lesion groups.Logistic multivariate analysis was used to identify relevant factors for uterine leiomyosarcoma.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of ultrasound elastography parameters in differentiating between uterine leiomyomas,atypical leiomyomas,and uterine leiomyosarcomas.Results The Adler blood flow grading and elastography scores in Group C were significantly higher than those in Groups A and B.The clear boundary rate of the masses,the strain ratio(SR)between normal myometrial tissue and pathological tissue,and the resistance index(RI)values were significantly lower in Group C compared to the other two groups the difference was statistically significant(P<0.05).Logistic multivariate analysis indicated that boundary distinctiveness,Adler grading,and elastography scoring were risk factors for uterine leiomyosarcoma the difference was statistically significant(P<0.05),while SR and RI were protective factors the difference was statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for ultrasound elastography parameters in differentiating uterine leiomyosarcoma was 0.876,with a sensitivity of 0.917 and specificity of 0.560.Conclusion Ultrasound elastography provides quantitative analysis parameters for diagnosing the nature of uterine leiomyoma lesions and assists in the differentia

关 键 词：超声弹性成像 子宫平滑肌瘤 非典型平滑肌瘤 子宫平滑肌肉瘤 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]