阴道彩色多普勒对子宫病变血流的研究

A Study for Blood Flow Hemodynamics in Uterine Disease by Endovaginal Color Doppler Ultrasonography

目的 总结 10年来应用阴道彩色多普勒对子宫病变血流的研究 ,以达到早期准确诊断子宫病变的目的。方法 经阴道彩色多普勒观察正常子宫 10 1例 ,早孕 10 5例和经手术病理证实 2 19例异常子宫病变血流及各种参数。结果 ①正常子宫和早孕子宫的各段动脉清晰显示 ,血流正常。早孕血流符合子宫—胎儿—胎盘循环状态。②不全流产显示残留组织实性光团及异常螺旋动脉。③侵蚀性葡萄胎和绒毛膜癌显示子宫肌壁各段动脉增粗 ,出现血窦 ,RI<0 .4。④子宫肌腺病为子宫增大 ,圆钝 ,血流丰富。⑤内膜息肉为宫腔内均质高回声 ,呈星点状血流 ;黏膜下肌瘤为宫腔内均质低回声 ,呈环状血流围绕 ;内膜腺癌为增多、增粗紊乱血流 ,RI <0 .4。结论 各种子宫病变均得到明确诊断 ,实用价值高。

Purpose To diagnose uterine disease early with the blood flow information summed up by endovaginal color Doppler in past ten years. Methods The blood flow characteristics such as degree of color imaging, morphology of velocity waveforms and hemodynamic parameters in 101 normal reproductive women. 105 normal early pregnant women and 219 patients who had been proved by histopathology were observed by endosavaginal color Doppler ultrasound (U.S.A Sequoia 512). Results ①The blood flow of uterine several arteries in normal women were all detected well, especially in early pregnancy. ②In incomplete abortion, if fluff tissue still lived, abnormal spiral artery whose peak systolic velocity was lower than in normal early pregnancy were seen. ③In invasion mole and choriocarcinoma, uterine several arteries were wider. Blood antra were detected in uterine wall and resistance index were lower than 0.4(RI<0.4). ④The adenomyosis became bigger. Uterine corpus was rounder and blunter. Flowing was abundant, but went in order. ⑤Endometrial polyp demonstrated uniform hyperechogenicity of the uterine cavity and there was a little flow in polyp. Submucous myoma was uniformly hypoechoic and cricoid flow encircle it. In endometrial carcinoma,endometrium wrer wide. Flowing became much more discord and resistance index were lower than 0.4(RI<0.4). Conclusion Uterine leison can be diagnosed accurately. It is helpful to clinic.