经阴道三维超声鉴别宫颈癌与宫颈肌瘤的价值

The value of transvaginal three-dimentional ultrasound for diagnosing cervical carcinoma and cervical leiomyoma

目的:评价经阴道三维超声对宫颈癌与宫颈肌瘤的鉴别价值。方法:回顾性分析经病理证实的宫颈肌瘤(34例)及宫颈癌(46例)的声像图表现,包括病灶的位置、形态、边界、血流以及周边脏器的浸润及淋巴结转移情况。结果:宫颈肌瘤主要发生于宫颈肌层(n=26),表现为膨胀性生长的低回声结节,形态规则,边界清晰,血供以周边环绕型为主,无周围脏器浸润亦无周边肿大淋巴结;宫颈癌主要发生于宫颈近外口处(n=41),表现为浸润性生长、不规则形态的低回声病灶,边界不清,血供丰富、紊乱。周边脏器可有受侵改变,可见周边淋巴结肿大。二者的形态、边界以及周边脏器浸润及淋巴结转移的差异有统计学意义(P<0.05),彩色血流信号丰富程度的差异亦有统计学意义(P<0.01)。结论:经阴道三维超声能立体、直观地反映宫颈病变的位置与范围,并可以显示宫颈肿物的血供,为鉴别宫颈肌瘤与宫颈癌提供了有价值的信息,可以较为准确地鉴别宫颈肌瘤和宫颈癌。

Objective： To investigate the value of transvaginal three-dimentional ultrasound in diagnosing cervical carcinoma and cervical leiomyoma.Methods： Thirty-four patients with cervical leiomyoma and fourty-six patients with cervical carcinoma were enrolled in the study who were examined by transvaginal three-dimentional ultrasound accompanied with color Doppler energy.The characteristics of the two diseases such as site,shape,boundary,blood flow,infiltration and lymph node metastasis were observed.Results： The cervical leiomyoma mainly located in the cervical myometrium（n=26）,and displayed as spherical hypoechoic nodules with clear boundary which surrounded by blood flow.The cervical carcinoma mainly located near cervical external os（n=41）,and displayed as hypoechoic lesions with irregular morphology and unclear boundary which had abundant and disordered blood supply.There were statistically significant differences between the two groups about morphology,boundary,blood flow,infiltration of surrounding organs and lymph node metastasis（P0.05）.Conclusions： Transvaginal three-dimentional ultrasound is a useful tool to investigate cervical mass,it can display the lesion and its vascularization stereoscopically and visually.It can provide some valuable information for diagnosing cervical carcinoma and cervical leiomyoma.