摘要
目的 比较宫腔内良性增生疾病采用经阴道和经腹部超声检查的诊断效能.方法 41 例子宫肌瘤、45 例子宫腺肌症、38 例子宫腺肌瘤患者,均经手术组织病理学检查确诊.入院后患者均同时进行经阴道和经腹部超声检查,以病理检查结果为对照,比较子宫肌瘤、子宫腺肌症及子宫腺肌瘤患者经阴道和经腹部超声检查的检出率;比较经阴道超声检查的病灶血流动力学及彩色多普勒血流显像(CDFI)血流信号分级.结果 经阴道超声检查子宫肌瘤、子宫腺肌症、子宫腺肌瘤的检出率分别为97.56%(40/41)、95.56%(43/45)、92.11%(35/38),明显高于经腹部超声的 75.61%(31/41)、73.33%(33/45)、71.05%(27/38),差异有统计学意义(P<0.05).子宫肌瘤、子宫腺肌症、子宫腺肌瘤患者经阴道超声检查的病灶血流收缩期峰值速度[(60.43±1.54)、(67.80±2.42)、(71.88±1.38)m/s]、舒张期峰值速度[(4.28±0.35)、(28.95±0.32)、(5.54±0.28)m/s]、搏动指数[(1.18±0.20)、(1.38±0.15)、(1.34±0.12)]、阻力指数[(0.55±0.16)、(0.74±0.12)、(0.76±0.10)]比较差异均有统计学意义(P<0.05).子宫腺肌症、子宫腺肌瘤患者经阴道超声检查的病灶血流收缩期峰值速度、舒张期峰值速度及搏动指数、阻力指数均高于子宫肌瘤患者,子宫腺肌瘤患者收缩期峰值速度高于子宫腺肌症患者,舒张期峰值速度低于子宫腺肌症患者,差异具有统计学意义(P<0.05).子宫肌瘤、子宫腺肌症、子宫腺肌瘤患者的CDFI 血流信号分级比较差异有统计学意义(P<0.05).结论 子宫肌瘤、子宫腺肌症及子宫腺肌瘤采用经阴道超声检查的检出率明显高于经腹部超声检查,且通过经阴道超声的病灶血流动力学参数及CDFI 血流信号分级有助于提高 3 种疾病的鉴别诊断效果.
Abstract
Objective To compare the diagnostic efficiency of transvaginal and transabdominal ultrasonography in the diagnosis of uterine fibroids,adenomyosis and adenomyoma.Methods 41 cases of uterine fibroids,45 cases of adenomyosis and 38 cases of adenomyoma were confirmed by surgical histopathological examination.After admission,transvaginal and transabdominal ultrasonography were performed simultaneously.The detection rates of transvaginal and transabdominal ultrasonography in patients with uterine fibroids,adenomyosis,and adenomyomas were compared using pathologic findings as a control.The focus hemodynamics and color Doppler flow imaging(CDFI)blood flow signal classification were compared between transvaginal ultrasonography.Results The detection rates of hysteromyoma,adenomyosis and adenomyoma by transvaginal ultrasonography were 97.56%(40/41),95.56%(43/45)and 92.11%(35/38),which were significantly higher than 75.61%(31/41),73.33%(33/45)and 71.05%(27/38)by transabdominal ultrasonography,and the difference was statistically significant(P<0.05).The peak systolic velocity[(60.43±1.54),(67.80±2.42),(71.88±1.38)m/s],peak diastolic velocity[(4.28±0.35),(28.95±0.32),(5.54±0.28)m/s],pulsation index[(1.18±0.20),(1.38±0.15),(1.34±0.12)],resistance index[(0.55±0.16),(0.74±0.12),(0.76±0.10)]in patients with uterine fibroids,adenomyosis,and adenomyoma were compared,and the difference was statistically significant(P<0.05).The peak systolic velocity,peak diastolic velocity,pulsation index and resistance index of patients with adenomyosis and adenomyoma were higher than those of patients with uterine fibroids;the peak systolic speed in adenomyoma patients was higher than that in adenomyosis patients,and the peak diastolic speed was lower than that in adenomyosis patients.The difference was statistically significant(P<0.05).There were significant differences in CDFI blood flow signal classification among patients with uterine fibroids,adenomyosis and adenomyomas(P<0.05).Conclusion The detection rate of uterine fibroids,adenomyosis and adenomyoma by transvaginal ultrasonography is significantly higher than that by transabdominal ultrasonography,and the focal hemodynamic parameters and CDFI blood flow signal classification by transvaginal ultrasonography can improve the differential diagnosis effect of the three diseases.
维普
万方数据