子宫肌瘤与子宫腺肌病超声造影鉴别诊断的价值

Value of Contrast-enhanced Ultrasonography in Distinguishing Hysteromyoma from Adenomyosis

目的探讨子宫肌瘤与子宫腺肌病超声造影(contrast-enhanced ultrasonography,CEUS)鉴别诊断的价值。方法收集有病理诊断的103例子宫肌瘤及76例子宫腺肌病患者的超声造影检查资料,进行回顾性分析。结果子宫肌瘤超声造影表现:环状增强型者89例(占86.4%),同步增强型者14例(占13.6%),向心填充型者0例(占0%)。子宫腺肌病超声造影表现:环状增强型者0例(占0%),同步增强型者47例(占82.5%),向心填充型者10例(占17.5%)。子宫肌瘤患者多为"环状增强型"(Z=-10.502,P<0.01)。子宫腺肌病患者多为"同步增强型"(Z=-8.562,P<0.01)和"向心填充型"(Z=-4.377,P<0.01)。结论子宫肌瘤与子宫腺肌病超声造影增强模式明显不同,超声造影是其有效影像学鉴别手段,其作为一种新的无创性检查方法,具有重要的临床价值。

Objective To investigate the value of contrast-enhanced ultrasonography（CEUS） in distinguishing hysteromyoma（HM） from adenomyosis（AM）. Methods A total of 103 cases with hysteromyoma and 76 cases with adenomyosis were retrospectively studied with CEUS. Results The enhancement patterns of hysteromyoma on CEUS were peripheral pseudocapsule type in 89 cases（86.4%）,synchronous type in 14 cases（13.6%）,and no case had centripetal type enhancement.The enhancement patterns of adenomyosis on CEUS were synchronous type in 47 cases（82.5%）,centripetal type in 10 cases（17.5%） and no case with peripheral pseudocapsule enhancement.The most of hysteromyoma are peripheral pseudocapsule type enhancement（Z=-10.502,P0.01）.While in adenomyosis,synchromous and centripetal enhancement（respectively Z=-8.562,P0.01 and Z=-4.377,P0.01） were the common type. Conclusion The enhancement pattern of hysteromyoma on CEUS was significantly different from adenomyosis.As a new non-invasive method,contrast-enhanced ultrasonography has important clinical value on the differential diagnosis of hysteromyoma and adenomyosis.