子宫内膜增生性病变与子宫内膜癌的超声诊断价值

Diagnostic Value of Ultrasound in Endometrial Hyperplasia and Endometrial Cancer

目的 :探讨子宫内膜增生性病变与子宫内膜癌的超声鉴别诊断及内膜癌肌浸程度的估价。方法 :采用术前B超、术后大体标本观察测量 ,对 12 3例子宫内膜病变患者的声像图资料进行分析并与手术后病理结果对照。结果 :①子宫内膜病变者子宫三径之和平均值均大于正常值 ;② 5 8 6 %的子宫内膜增生过长病变患者内膜形态以条形、梭形和正常形态回声 ;35 %的Ⅱ期以上子宫内膜癌患者内膜回声以积液为主兼有其它图像类型 ;③大于 5 0岁患者不同病理类型病变的子宫内膜平均厚度均超过其正常内膜厚度值 ,但无明显的规律性。小于 5 0岁的患者内膜增厚主要以子宫内膜增生过长病变为主占 4 8% ;④通过超声测量子宫内膜厚度判断子宫内膜癌浅肌层和深肌层浸润符合率均为 71 4 %。结论 :超声检查对判断子宫内膜病变病理类型有一定帮助 ,内膜厚度、内膜形态、回声特点、及内膜与肌层间的关系等 ,仅提示病变存在的可能性 ,要鉴别病变的良恶性、肌层浸润深度 。

Objective:To probe the differential diagnosis between endometrial hyperplasia and endometrial cancer and evaluate the extent of myometrial invasion of endometrial cancer.Methods:Preoperative sonographic findings of 123 cases with pathological changes of endometrium were analyzed and compared with postoperative pathologic results.Results:①The average values of uterine measure in endometrial diseases were higher than normals.②58.6% Vltrasound echography were zonal,shuttle and normal in endometrial hyperplasia;35% were alike to that of hydrops combined with other types in endometial cancer of over Ⅱstaging.③Endometrial thickness was higher than normal in patients aged over 50 years,but without clear regulation,and in 48% patients younger than 50 years.④The extent of myometrial invasion of endometrial cancer was estimated by endometrial thickness detected by ultrasound.The coincident rate was 71.4% in cancers unreached into myometrium longus,58.8% in cancers invaded into myometrium profundus.Conclusions:Ultrasound is helpful to diagnose pathologic types of endometrial diseases.Combined endometrial thickness,endometrial form,characteristic of echo with the relation between endometrium and myometrium can distinguish benign or malignant pathology and extent of myometrial invasion.