子宫肌瘤和局限型腺肌病超声弹性图像特征分析

Analysis of the elastosonography of uterine leiomyoma and focal adenomyosis

目的 探讨经阴道超声弹性成像应用于子宫肌瘤和局限型腺肌病诊断中的可行性及其价值。方法回顾性分析经手术后病理证实的50例子宫肌瘤患者（60枚肌瘤）和15例子宫局限型腺肌病患者（15处腺肌病病灶）的经阴道超声弹性图像，以及病灶与正常肌层间的顺应性比值（B／A）。结果 60枚肌瘤与正常肌层的B／A为1．05～10．40，平均3．13±1．80；15处局限型腺肌病病灶与周围正常肌层的B／A为0．32～0．83，平均0．52±0．15。肌瘤与正常肌层B／A、局限型腺肌病病灶与正常肌层B／A比较差异有统计学意义（P=0．00）。结论 经阴道超声弹性成像能较准确地反映子宫常见疾病的硬度变化，肌瘤硬度大于正常肌层，腺肌病的硬度小于正常肌层，在子宫疾病的鉴别诊断中有一定的应用前景。

Objective To investigate the application feasibility and the value of vaginal ultrasonic elastography in diagnosing uterine leiomyoma and focal adenomyosis. Methods The elastography images from 50 patients with uterine leiomyoma （60 leiomyomas ） and 15 patients with focal adenomyosis（ 15 lesions ） confirmed by post-operative pathological results were retrospectively analyzed. The compliance ratio （ ratio of B/A ） of lesions and normal muscles was compared. Results The compliance ratios （B/A） of the 60 uterine leiomyomas to the normal muscles ranged from 1.05 to 10.40, with average of 3.13 ± 1.80; while the B/A of the 15 adenomyosis lesions to the normal muscles ranged from 0.32 to 0.83, with average of 0.52 ± 0.15. There was significant difference （P=0.00）. Conclusion The elastosonography can accurately provide the stiffness changing information of the common uterine diseases, the stiffness of uterine leiomyomas is higher than that of normal muscle, and that of adenomyosis lesions is lower than normal muscle, ant it may be useful in differential diagnosis of other uterine diseases in the future.