经阴道彩色多普勒超声诊断子宫肌瘤和子宫肌腺病

Diagnosis of leiomyoma and adenomyosis with transvaginal color Doppler ultrasonography

目的探讨经阴道彩色多普勒超声(TVCDU)对子宫肌瘤和子宫肌腺病的诊断价值。方法应用经阴道彩色超声诊断仪,对45例子宫肌瘤和28例子宫肌腺病患者行术前检查,包括灰阶图像和彩色血流成像;术后均经病理证实。结果超声检查诊断子宫肌瘤共42例,子宫肌腺病34例。与病理结果对照:3例子宫肌瘤被误诊为子宫肌腺病,6例子宫肌腺病被误诊为子宫肌瘤,子宫肌瘤的诊断符合率为92.8%,子宫肌腺病符合率为82.5%。二维灰阶超声:子宫肌瘤和子宫肌腺病各有特点,子宫肌瘤内部血流丰富,而子宫肌腺病只有星点样血流;子宫肌瘤随着体积的增大,彩色血流的丰富程度也随之增加,而子宫肌腺病不具备上述特征。结论应用TVCDU二维灰阶成像可鉴别子宫肌瘤和子宫肌腺病,二者的诊断正确率均较高;联合应用灰阶图像及彩色图像,有利于提高诊断的正确率。

Objective To assess the value of transvaginal color Doppler ultrasonography(TVCDU)in diagnosing leiomyoma and adenomysis ultrasound.Methods A total of 45 leiomyoma and 28 adenomyosis underwent TVCDU before operation and pathology was performed after operation.The gray and color Doppler flow imaging(CDFI)were observed.Results A total of 42 leiomyoma and 34 adenomyosis were diagnosed with ultrasound.Comparison with pathological results,3 leiomyoma were misdiagnosed as adenomyosis and 6 adenomyosis were misdiagnosed as leiomyoma.The diagnosis accurate rate was 92.8% for leiomyoma,and 82.5% for adenomyosis.The grey ultrasound features:two diseases had its own character respectively;leiomyoma had rich and abundant blood supply,but adenomyosis only had star-spotted blood supply.The bigger the volume of leiomyoma was,the more abundant blood flow of the mass was,but the adenomyosis didn't had this sign.Conclusion TVCDU can be used to differentiate the leiomyoma from adenomyosis,and the diagnosis accurate rate both are quite high,especially for leiomyoma.The grey ultrasonography combined with CDFI contributes to improve the diagnosis accuracy rate.