子宫腺肌症MRI、超声及血清肿瘤标志物诊断分析与评价

Evaluation and Analysis of MRI,Sonography and Tumor Markers of Serum in the Diagnosis of Uterine Adenomyosis

目的评价MRI、超声及血清肿瘤标志物对子宫腺肌症的诊断价值。资料与方法对病理证实的45例子宫腺肌症与36例子宫肌瘤患者术前行超声(经腹、经阴道)、MRI及血清CA125、CA153、CA199测定。分析各项检查诊断子宫腺肌症的敏感性、特异性及准确性。结果MRI诊断子宫腺肌症的敏感性为95.56%,特异性为100%,准确性为97.53%;经阴道超声为80.0%、88.89%、83.95%;经腹部超声为68.89%、83.33%、75.31%;血清CA125为46.67%、88.89%、65.43%;CA153为33.33%、94.44%、60.49%;CA199为15.56%、97.22%、51.85%。MRI、经阴道超声、经腹超声、血清CA125、CA153、CA199诊断子宫腺肌症的敏感性(χ2=83.213,P<0.01)、准确性(χ2=56.216,P<0.01)有非常显著统计学意义,特异性(χ2=9.513,P>0.05)无统计学意义。结论对于子宫腺肌症的诊断,MRI、超声及血清肿瘤标志物均有一定价值,MRI、超声检查优于血清肿瘤标志物(CA125、CA153、CA199)指标,MRI是最有价值的检查手段。

Objective To investigate the role of MRI, sonography and tumor markers of serum in the diagnosis of uterine adenomyosis. Materials and Methods MRI, sonography （transabdominal and transvaginal sonography ）and estimation of serum CA125, CA199 and CA153 levels were carried out in 45 patients confirmed pathologically as uterine adenomyosis and 36 patents with leiomyoma before operation. The sensitivity, specificity and accuracy were analyzed respectively. Results The sensitivity, specificity and accuracy of MR in the diagnosis of uterine adenomyosis were 95.56% , 100% and 97.53%, those of TVS were 80.0% ,88.89% and 83.95% , those of TAS were 68.89% ,83.33% and 75.31% , those of serum CA125 levels were 46.67% ,88.89% and 65.43% , those of serum CA153 levels were 33.33% ,94.44% and 60.49% , those of serum of CA199 levels were 15.56% ,97.22% and 51.85%. The difference was much significant on sensitivity and accuracy in diagnosing the uterine adenomyosis and not significant on specificity. Conclusion MRI, sonography and tumor markers of serum are helpful to diagnose the uterine adenomyosis. However, MRI, transvaginal and transabdominal sonography are superior to CA125,CA199 and CA153 of serum, MRI is the best modality of them.