经阴道彩色多普勒在子宫肌瘤及子宫腺肌瘤诊断中的应用

Usefulness of Transvaginal Color Doppler Sonography in Diagnosing Hysteromyoma and Adenomyoma

目的:探讨经阴道超声二维及彩色多普勒诊断子宫肌瘤及子宫腺肌瘤的临床应用价值。方法:对35例子宫腺肌瘤、42例子宫肌瘤患者行经阴道彩色多普勒超声,分析其二维及彩色多普勒血流特征,并测定各组子宫动脉、病灶周边及内部RI。选取50名健康妇女为正常对照组。结果:二维图像上子宫肌瘤及子宫腺肌瘤均呈特征性改变。CDFI示子宫肌瘤及子宫腺肌瘤患者子宫动脉平均RI低于正常对照组(P<0.05)。子宫肌瘤周边血流丰富,内部血流信号稀少或无;子宫腺肌瘤周边血流信号稀少,内部见丰富或星点状血流信号,子宫肌瘤周边及内部动脉RI均低于子宫腺肌瘤内部动脉RI(P<0.05)。结论:经阴道彩色多普勒为子宫肌瘤及子宫腺肌瘤的鉴别诊断提供有价值的信息。

Objective To explore the clinical value of transvaginal two dimensional and color Doppler ultrasonography in diagnosing uterine hysteromyoma and adenomyoma. Methods Transvaginat color doppler sonographywas performed in 42 cases with hysteromyoma and35 cases with adenomyoma to analyze the characteristics of transvaginal two dimensional and color doppler flow with them,and to measurate the resistance index（RI） of uterine artery and the RI of focus. 50 normal women were chosen for control. Results Characteristic changes were observed in the transvaginaltwo dimensionalultrasonography of both the hysteromyoma and adenomyoma. Color doppler flow imaging was as following; RI of uterine artery of hysteromyoma and adenomyoma were lower than that of control group（P〈0.05）. The blood stream at the edge of mass in patients with hysteromyoma was rich and abundant,and the sparse or absence of blood flow imagingin its interior. The blood stream at edge of mass in patients with adenomyoma was sparse or absence, and there was rich blood flow or starlike flicker color blood signal in the interior. The values of RI within and at the egde of the hysteromyoma was lower than in the adenomyoma＇s interior. Conclusion Transvaginal color doppler ultrasonogrphy provided differential diagnosis in hysteromyoma and adenomyoma.