TVCDFI技术在子宫肌瘤与子宫腺肌瘤鉴别诊断中的价值

A comparaive study on transvaginal color Doppler sonography diagnosis of uterine adenomyoma with hysteromyoma

目的探讨经阴道彩色多普勒血流显像技术(TVCDFI)对子宫肌瘤和子宫腺肌瘤的诊断和鉴别诊断意义。方法以手术病理诊断为标准,回顾性地分析子宫肌瘤和子宫腺肌瘤的TVCDFI特征,对照比较二者瘤体包膜回声、瘤体内部回声、彩色血流信号和RI值的差异。结果子宫肌瘤与子宫腺肌瘤声像图的鉴别以瘤体周边假包膜特征最为重要;彩色多普勒血流显示瘤体周边出现环状彩色血流,子宫肌瘤组占95.9%,子宫腺肌瘤组占30.8%,组间差异明显;子宫肌瘤和子宫腺肌瘤周边血流阻力指数(RI)分别是0.53±0.07和0.67±0.057,RI≥0.7分别是1.4%和38.5%,组间存在显著性差异(P<0.05)。结论结合瘤体包膜回声、彩色血流信号和RI等超声特征能提高TVCDFI对子宫肌瘤和子宫腺肌瘤的诊断和鉴别诊断率。

Objective To evaluate the significance of transvaginal color doppler sonography （TVCDS） in the diagnosis and differential diagnosis of uterine Adenomyoma （UA） and hysteromyoma （HT）. Methods According to the conclusions of the pathology from operation, the TVCDS features of hysteromyoma and endometrioma was analyzed retrospectively, further we could compare the differences of the thecal and internal echo and the signal of the color blood flow between the two tumors. Results The differences of sonogram and the ultrasonic features of pseudo - capsule in peripheral tissue were highly important for differential diagnosis between hysteromyoma and uterine adenomyoma; the ratio of the circular blood signal of color Doppler ultrasound were 95.9% in HT group and were 30.8% in UA group. There was significant difference between two groups; the Resistance indeix （RI） of the peripheral tissue of hysteromyoma and uterine adenomyoma was 0.53 ± 0.07 and 0.67 ± 0.053; the ratio was （RI≥0.7） 1.4% and 38.5% respectively. There also was significant difference between the two groups（ P 〈 0.05）. Conclusion The diagnostic accuracy of UA and HT can be elevated using color flow signal in combination with the thecal echo and RI.