The Preoperative Differential Diagnostic Value of Ultrasound Elastography in Uterine Leiomyomas,Atypical Leiomyomas,and Uterine Leiomyosarcomas
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 differential diagnosis of uterine leiomyosarcoma,offering significant clinical application value.
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