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经阴道超声联合超声造影诊断子宫肌瘤效率

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目的:探讨经阴道超声联合超声造影(CEUS)诊断子宫肌瘤效果.方法:回顾性分析2021年1月-2023年1月本院收治且经手术病理确诊的112例子宫肌瘤患者临床资料,均经阴道超声和CEUS检查,与手术病理结果进行比较,分析经阴道超声、CEUS检查和二项联合诊断子宫肌瘤价值.结果:112例中Ⅰ型72例、Ⅱ型40例,黏膜下肌瘤21例、肌壁间肌瘤62例、浆膜下肌瘤29例,单发肌瘤58例、多发肌瘤54例,共检查出病灶数173个,其中黏膜下肌瘤病灶数25个、肌壁间肌瘤病灶数112个、浆膜下肌瘤病灶数36个.与病理结果比较,经阴道超声联合CEUS诊断子宫肌瘤的准确率为100.0%,高于阴道超声(89.3%)和CEUS(93.8%);漏诊率为0,低于阴道超声(10.7%)和CEUS(6.3%)(均P<0.05).经阴道超声联合CEUS诊断Ⅰ型、Ⅱ型子宫肌瘤的准确率均为100.0%,均高于阴道超声(90.3%、87.5%)和CEUS(94.4%、90.0%);经阴道超声联合CEUS对肌壁间肌瘤诊断率高于经阴道超声、CEUS单独诊断(均P<0.05),3种诊断方式对黏膜下肌瘤、浆膜下肌瘤诊断率无差异(P>0.05);经阴道超声联合CEUS对肌壁间肌瘤的病灶检出率高于经阴道超声、CEUS单独诊断(均P<0.05),3种诊断方式对黏膜下肌瘤、浆膜下肌瘤病灶检出率无差异(P>0.05).结论:经阴道超声联合CEUS提高了诊断子宫肌瘤效率,并可准确判断子宫肌瘤的位置、分型及数目,对肌壁间肌瘤检出率较高.为临床选择治疗方案提供依据.
Efficacy of transvaginal ultrasound combined with contrast-enhanced ultrasound for diagnosing the uterine myoma
Objective:To investigate the efficacy of transvaginal ultrasound combined with contrast-enhanced ultrasound(CEUS)for diagnosing the uterine myoma.Methods:The clinical data of 112 patients with uterine myomas confirmed by surgery and pathology who were admitted to the hospital from January 2021 to January 2023 were analyzed retro-spectively.All patients were given the examination by transvaginal ultrasound and CEUS.The results of the examina-tion by transvaginal ultrasound and CEUS of the patients were compared with their pathological results.The value of transvaginal ultrasound or CEUS alone,or the combination of transvaginal ultrasound and CEUS of the patients for di-agnosing their uterine myoma was analyzed.Results:In 112 patients with uterine myomas,there were 72 cases with type Ⅰ of uterine myomas and 40 cases with type Ⅱ of uterine myomas,there were 21 cases with submucosal leiomy-oma,62 cases with intramural leiomyoma and 29 cases with subserous leiomyoma,and there were 58 cases with single leiomyoma and 54 cases with multiple leiomyoma.A total of 173 lesions of the uterine myomas of the patients were found,including 25 lesions of submucosal myomas,112 lesions of intramural leiomyoma and 36 lesions of subserous myomas.Compared with that of pathological results,the accuracy of the combination of transvaginal ultrasound and CEUS for diagnosing the uterine myoma was 100.0%,which was significantly higher than that(89.3%)of transvaginal ultrasound and that(93.8%)of CEUS.The rate of the missed diagnosis of the combination of transvaginal ultrasound and CEUS for the uterine myoma was 0,which was significantly lower than that(10.7%)of transvaginal ultrasound and that(6.3%)of CEUS(all P<0.05).The accuracy of the combination of transvaginal ultrasound and CEUS for di-agnosing the type Ⅰ of uterine myoma or the type Ⅱ of uterine myoma was 100.0%,which was significantly higher than that(90.3%or 87.5%)of transvaginal ultrasound and that(94.4%or 90.0%)of CEUS.The diagnostic rate of the combination of transvaginal ultrasound and CEUS of the patients for diagnosing their uterine myoma was significantly higher than that of transvaginal ultrasound or CEUS alone(all P<0.05).There was no significant difference in the di-agnostic rate for the submucosal and subserous uterine myoma among the three diagnostic methods(P>0.05).The de-tection rate of the combination of transvaginal ultrasound and CEUS for diagnosing the uterine myoma was significantly higher than that of transvaginal ultrasound or CEUS alone(all P<0.05).There was no significant difference in the de-tection rate of the submucosal and subserous uterine myoma among the three diagnostic methods(P>0.05).Conclu-sion:The combination of transvaginal ultrasound and CEUS of the patients for diagnosing their uterine myoma im-proves the diagnostic efficacy,which can help to determine the location and number of uterine myomas accurately,and has higher detective rate for the subserous uterine myoma.The combination of transvaginal ultrasound and CEUS of the patients provides the evidences for selecting the reasonable treatment plan in clinical practice.

Uterine myomaTransvaginal ultrasoundContrast-enhanced ultrasoundClassificationTypeLesionDetective efficacy

王丽、巨学明、胡梅

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四川省广汉市人民医院(618300)

四川省人民医院

西南医科大学附属医院

子宫肌瘤 经阴道超声 超声造影 分型 类型 病灶 检出效率

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(1)
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