经阴道彩色多普勒超声联合诊断性刮宫对早期子宫内膜癌分期的临床研究

Clinical Study of Transvaginal Color Doppler Sonography and Diagnostic Curettage in Early Stage of Endometrial Carcinoma

目的:探讨经阴道行彩色多普勒超声(TVCDS)联合诊断性刮宫对早期子宫内膜癌分期的诊断价值。方法:回顾性分析108例行诊断性刮宫和TVCDS检查确诊并经手术病理证实的临床Ⅰ期子宫内膜癌患者的临床资料,根据诊断性刮宫的病理结果,分析声像图特征、彩色多普勒血流图(CDFI)特点及血流阻力指数(RI),判断肿瘤浸润子宫肌层的深度,进行临床分期。结果:诊断性刮宫准确率达98.15%。TVCDS分期与病理总符合率为74.07%;TVCDS测得子宫内膜厚度为5.0～43.0mm,平均17.0±2.8mm,ⅠA、ⅠB、ⅠC各期之间比较,差异有高度统计学意义(P<0.01);CDFI均为低阻力型血流,RI为0～0.65,平均0.45±0.15,ⅠA、ⅠB、ⅠC各期之间比较,差异有高度统计学意义(P<0.01)。结论:TVCDS联合诊断性刮宫是目前诊断早期子宫内膜癌并进行临床分期的最简便有效的方法之一,为临床选择手术方法和判断预后提供重要依据。

Objective：To evaluate the clinical value of transvaginal color Doppler sonography （TVCDS） combined with diagnostic curettage in patients with early stage of endometrial carcinoma. Methods; TVCDS and diagnostic curettage were performed in 108 patients with early stage of endometrial carcinoma to diagnose the depth of myometrial invasion according to ultrasound and color Doppler flow imaging （CDFI） and blood stream drag index （RI）, make clinical stage. Results： The diagnostic accuracy of diagnostic curettage was 98.15%. Coincidence of TVCDS stage and clinico-pathology was 74.07% of endernetr.ial carcinoma. The endometdal thickness by transvaginal ultrasound was 5.0-43.0 mm （average 17.0±2.8 mm） ,there were significantly statistical difference among stage Ⅰ A, Ⅰ B,and Ⅰ C （ P 〈 0.01 ）. The ratio of CDFI was low- resistance blood stream RI = 0 - 0.65 （ mean 0.45 ± 0.15）, and there were significant difference among stage Ⅰ A, ⅠB, and Ⅰ C（ P 〈 0.01 ） .Conclusions：TVCDS combined diagnostic curettage is now the best way for diagnosis and clinical stage of early stage endometrial carcinoma, and should be a useful way in making operative method and judging prognosis of early stage of endometrial carcinoma.