经阴道三维超声预测绝经后阴道出血患者内膜恶变风险

Prediction of Intimal Malignant Transformation Risk in Postmenopausal Vaginal Bleeding Patients by Transvaginal three-dimensional Ultrasound

目的探讨经阴道三维能量多普勒超声(3D-PDA)预测绝经后阴道出血患者患子宫内膜癌的价值。方法采用回顾性分析,收集2018年12月至2019年10月于郑州大学第二附属医院就诊的220例绝经后阴道出血患者,以子宫内膜病理结果为检验标准,所有患者术前均常规行经阴道三维多普勒超声,使用VOCAL软件计算子宫内膜体积(EV)和3D-PDA血管指数(血管化指数(VI),血流指数(FI)和血管化血流指数(VFI)。结果220例患者中,良性子宫内膜病变188例(85.4%),子宫内膜癌(EC)32例(14.6%)。子宫内膜癌患者的子宫内膜更厚(15.64±7.26 mm vs7.03±3.42mm;P<0.05),子宫内膜容积更大(9.03±2.0 mL vs 3.26±2.04 mL,P<0.05),EC组血流参数VI、FI、VFI均高于良性子宫内膜病变组(P<0.05)。结论三维能量多普勒超声不仅可以清晰显示子宫内膜微小病变,还可以测量子宫内膜体积以及对血流定量分析,对于预测绝经后阴道出血罹患子宫内膜癌有一定的临床应用价值。

Objective To evaluate the value of transvaginal three-dimensional energy Doppler ultrasound(3D-PDA)in predicting endometrial carcinoma in patients with postmenopausal vaginal bleeding.Methods 220 cases of postmenopausal vaginal bleeding treated in the second affiliated Hospital of Zhengzhou University from December 2018 to October 2019 were analyzed retrospectively.according to the pathological results of uterus,all patients underwent routine transvaginal three-dimensional Doppler ultrasound before operation.VOCAL software was used to calculate the intimal volume(EV)and 3D-PDA vascular index(vascularization index(VI),blood flow index(FI)and blood vessels).Blood flow index(VFI).Results There were 188 cases(85.4%)of benign intimal lesions and 32 cases(14.6%)of(EC).The intima of patients with endometrial carcinoma was thicker(15.64±7.26 mm vs 7.03±3.42 mm;P<0.05),and the volume of uterus was larger(9.03±2.08 mL vs 3.26±2.04 mL,P<0.05).The VI,FI,VFI of blood flow parameters in,EC group was higher than that in benign intimal lesion group(P<0.05).Conclusion On Three-dimensional energy doppler ultrasound cannot only clearly show the small endometrial lesions,but also measure the endometrial volume and quantitative analysis of blood flow,which has a certain clinical application value in predicting endometrial cancer in postmenopausal vaginal bleeding.