二维超声联合实时组织超声弹性成像鉴别子宫内膜良恶性病变的价值  

Value of two-dimensional ultrasound combined with real-time ultrasound elastography in differentiating benign and malignant endometrial lesions

作　　者：赵丽文 倪玮爱 曹莉 ZHAO Liwen;NI Wei'ai;CAO Li(Department of Ultrasound Diagnosis,Yingtan Maternal and Child Health Hospital,Yingtan,Jiangxi,335000,China)

机构地区：[1]鹰潭市妇幼保健院超声诊断科,江西鹰潭335000

出　　处：《当代医学》2024年第23期80-84,共5页Contemporary Medicine

摘　　要：目的分析二维超声联合实时组织超声弹性成像(real-time tissue ultrasound elastography,RTUE)鉴别子宫内膜良恶性病变的价值。方法回顾性分析2020年5月至2022年5月鹰潭市妇幼保健院收治的80例子宫内膜病变患者的临床资料,以病理检查结果作为诊断金标准,分析二维超声、RTUE及联合检测的结果及诊断价值,比较良性与恶性患者临床资料和超声参数,采用多因素Logistic回归分析发生子宫内膜恶性病变的影响因素。结果80例子宫内膜病变患者中,术后病理检查检出恶性18例,良性62例;二维超声检出16例恶性,良性64例;RTUE检出17例恶性,良性63例;联合检查检出恶性20例,良性60例。3种检查方式诊断子宫内膜癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值差异无统计学意义,但联合检查诊断的灵敏度、准确度、阴性预测值最高,分别为94.44%、95.00%、98.33%,与术后病理诊断的一致性最高(Kappa=0.862)。良性与恶性患者年龄、体重指数(body mass index,BMI)、内膜厚度及血流分级比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,BMI高、内膜厚度厚、血流分级高是发生子宫内膜恶性病变的独立危险因素(P<0.05)。结论二维超声联合RTUE诊断子宫内膜恶性病变的准确度较高,可降低疾病漏诊率,BMI高、内膜厚度厚、血流分级高是发生子宫内膜恶性病变的独立危险因素,可为子宫内膜癌的诊断提供相关参考依据。Objective To evaluate the value of two-dimensional ultrasound combined with real-time tissue ultrasound elastography(RTUE)in differentiating benign and malignant endometrial lesions.Methods The clinical data of 80 patients with endometrial lesions admitted to Yingtan Maternal and Child Health Hospital from May 2020 to May 2022 were retrospectively analyzed.The results of two-dimensional ultrasound,RTUE and combined detection were analyzed,and the clinical data and ultrasonic parameters were compared between benign and malignant patients.Multivariate Logistic regression analysis was used to investigate the influencing factors of endometrial malignant lesions.Results Among the 80 cases of endometrial lesions,pathological examination showed that 18 cases were malignant and 62 cases were benign;16 cases of malignancy and 64 cases of benign were detected by two-dimensional ultrasound;17 cases of malignant and 63 cases of benign were detected by RTUE;20 cases of malignant cases and 60 cases of benign were detected by combined examination.There was no significant difference in sensitivity,specificity,accuracy,positive predictive value and negative predictive value in the diagnosis of endometrial cancer among the three methods,but the sensitivity,accuracy and negative predictive value of combined examination were the highest,which were 94.44%,95.00%and 98.33%,respectively;the consistency with postoperative pathological diagnosis was the highest(Kappa=0.862).There were significant differences in age,body mass index(BMI),intima thickness and blood flow classification between benign and malignant patients(P<0.05).Multivariate Logistic regression analysis showed that higher BMI,thicker endometrial thickness and higher blood flow grade were independent risk factors for malignant endometrial lesions(P<0.05).Conclusion two-dimensional ultrasound combined with RTUE is highly accurate in the diagnosis of endometrial malignant lesions and can reduce the rate of missed diagnosis,higher BMI,thicker endometrial thickness and higher b

关 键 词：子宫内膜病变 二维超声 超声弹性成像 诊断价值 

分 类 号：R73[医药卫生—肿瘤]