经腹超声造影对子宫肌层良性病变的诊断价值

Diagnostic value of transabdominal contrast-enhanced ultrasound in benign myometrial lesions of the uterus

目的探讨经腹超声造影(CEUS)诊断子宫肌层良性病变的价值。方法随机选择2022年9月—2023年8月在徐州市中心医院接受超声(US)及CEUS检查的子宫腺肌病、子宫肌瘤患者各50例,观察并比较子宫腺肌病及子宫肌瘤的CEUS增强方式、增强程度、消退方式、增强均匀度、增强后边界等定性指标,以及达峰时间(TTP)、峰值强度(PI)、平均渡越时间(MTT)等定量指标;构建受试者工作特征曲线(ROC),获得曲线下面积(AUC),比较US和CEUS的诊断效能(敏感度、特异度、阳性预测值、阴性预测值、准确度)。结果所有患者经US检出子宫腺肌病38例,子宫肌瘤40例,诊断符合率78%;经CEUS检出子宫腺肌病48例,子宫肌瘤47例,诊断符合率95%。子宫腺肌病与子宫肌瘤的增强均匀度、增强后边界及消退方式比较,差异有统计学意义(P<0.05);增强方式及增强程度比较,差异无统计学意义(P>0.05)。子宫腺肌病TTP为(39.72±5.72)s,短于子宫肌瘤TTP[(43.26±5.01)s],PI为(70.11±4.58)%,低于子宫肌瘤PI[(75.84±4.17)%],差异有统计学意义(P<0.05);子宫腺肌病与子宫肌瘤的MTT分别为(85.54±6.16)s、(83.73±5.83)s,两者比较差异无统计学意义(P>0.05)。US的AUC为0.78,CEUS的AUC为0.95;CEUS诊断子宫腺肌病的敏感度、特异度、阳性预测值、阴性预测值、准确度均优于US,差异均有统计学意义(P<0.05)。结论CEUS有助于诊断子宫腺肌病和子宫肌瘤,能够有效提升诊断结果的准确性,具有临床应用价值。

Objective To explore the diagnostic value of transabdominal contrast-enhanced ultrasound(CEUS)in benign myometrial lesions of the uterus.Methods A total of 50 adenomyosis patients and 50 hysteromyoma patients who were subject to ultrasound(US)and CEUS in Xuzhou Central Hospital from September 2022 to August 2023 were select-ed.Their qualitative indexes including the enhancement mode,enhancement degree,regression mode,enhancement uni-formity and enhanced boundary,as well as quantitative indexes including time to peak(TTP),peak intensity(PI)and mean transit time(MTT)were observed and compared.A receiver operating characteristic(ROC)curve was construc-ted,obtaining the area under the curve(AUC)and the diagnostic efficiency such as sensitivity,specificity,positive pre-dictive value,negative predictive value,and accuracy of US and CEUS was compared.Results Through US,38 cases of adenomyosis and 40 cases of hysteromyoma were diagnosed,with a diagnostic consistent rate of 78%.Through CEUS,48 cases of adenomyosis and 47 cases of hysteromyoma were diagnosed,with a diagnostic consistent rate of 95%.There were significant differences between adenomyosis and hysteromyoma in enhancement uniformity,boundary after enhancement and regression mode(P<0.05).There were no statistical differences in enhancement mode or enhancement degree(P>0.05).The TTP of adenomyosis was(39.72±5.72)s,which was shorter than(43.26±5.01)s for hysteromyoma,and the PI of adenomyosis was(70.11±4.58)%,which was lower than(75.84±4.17)%for hysteromyoma,with statistical significances(P<0.05).The MTT of adenomyosis and hysteromyoma was(85.54±6.16)s and(83.73±5.83)s re-spectively,without statistical difference(P>0.05).The AUC of US and CEUS was 0.78 and 0.95,respectively.CEUS showed better sensitivity,specificity,positive predictive value,negative predictive value and accuracy than CEUS in di-agnosing adenomyosis,with statistical differences(P<0.05).Conclusions CEUS is useful to diagnose adenomyosis and hysteromyoma,and can effectively improve the accuracy of diagnosis results,with clinical application value.