经阴道超声在子宫腺肌症与子宫肌瘤鉴别诊断中的应用

Research on the application of transvaginal ultrasound in diagnosis between adenomyosis and uterine fibroids

目的探讨子宫肌瘤和子宫腺肌症的超声表现,以及经阴道超声在两者诊断和鉴别诊断的价值。方法回顾分析经病理证实的96例子宫肌瘤和132例子宫腺肌症患者的临床资料和经阴道超声表现,进行归纳总结。结果子宫肌瘤声像图为切面内见圆形等回声或低回声团块,边界清,形态规则,内部回声呈多样性不均匀,团块周边见环状或半环状血流,内部有时见棒条状血流;子宫腺肌症声像图为子宫不均匀性增大,形态饱满,子宫切面内见肌壁呈弥漫性或局灶性增厚较明显,呈粗糙光点回声增强,边缘不清、欠规则,病灶区内血流少,见稀疏的短条状血流。结论经阴道超声可获得高分辨率、高清晰度的图像,能比腹式更清晰地显示子宫肌壁内的细微改变、病变周围有无包膜以及病变区域的血流等情况,对子宫肌瘤和子宫腺肌症诊断和鉴别诊断具有重要价值。

Objective To explore the performance of transvaginal ultrasound in adenomyosis and uterine fibroids and find out the value of the diagnosis and identification between these two cases.Methods Analyzing 96 cases of pathologically confirmed uterine fibroids and 132 cases of adenomyosis,and making conclusions after examing their clinical profiles and reflections in the ultrasound.Results The audio-visual photo of uterine fibroids showed echo or round hypoechoic mass in clear boundary,regular type.The inner echo was diverse and uneven,around which there were circles and half circled blood fluids,sometimes with column fluids;while the photo of adenomyosis showed the uterus increases unevenly,with the full shape.It was found that the muscle inside the uterus wall aspect showed diffuse or focal low flow areas,the rough spots had stronger echo,unclear boundary,irregular shape and the short strip sparse blood.Conclusion Transvaginal ultrasound made high-resolution and high-definition images available.Compared with abdominal unltrasound it made subtle changes in the muscle wall of the uterus,lesions around the capsule as well as the availability of regional blood flow lesions clearer.The research was valuable in diagnosis and identification between uterine fibroids and adenomyosis.