经阴道超声弹性成像对子宫内膜良恶性疾病的诊断与鉴别

The diagnosis and identification of endometrial benign and malignant diseases through vaginal ultrasound elastography

目的通过应用经阴道超声弹性成像技术、弹性成像评分法、应变率比值法对子宫内膜良恶性疾病进行分析并比较。方法选取64名子宫内膜病变患者,行经阴道超声及经阴道超声弹性成像检查,并与20名对照组(正常人)进行比较。最后计算并比较超声弹性5级评分法和应变率比值法对子宫内膜良恶性病变的诊断情况。结果经阴道超声技术与弹性成像技术结合后的灵敏度为88. 9%,特异性为92. 9%.两者分别与结合成像对比,统计结果分别为(χ~2=4. 18,P <0. 05;χ~2=6. 56,P <0. 05),有统计学差异。弹性5级评分法诊断子宫内膜疾病的灵敏度、特异性和准确性分别为88. 9%,85. 7%,87. 5%.应变率比值法诊断子宫内膜疾病的灵敏度、特异性和准确性分别为91. 7%,89. 3%,90. 6%.由此看出,应变率比值法从灵敏度、特异性和准确度三方面均稍高于弹性评分法,两者间无统计学差异(P> 0. 05)。结论经阴道超声弹性成像在子宫内膜疾病的性质的诊断与鉴别中有十分重要的临床价值。

Objective To analyze and compare endometrial benign and malignant diseases by using ultrasound elastography,elastic imaging scoring and strain rate ratio. Methods Sixty-four patients with endometrial lesion were selected and compared with 20 controls( normal people). Finally,the diagnosis of benign and malignant endometrial lesions was calculated and compared with the method of ultrasonic elasticity 5 and strain rate ratio. Results The sensitivity of transvaginal ultrasonography and elastic imaging technology was 88. 9% and specificity 92. 9%. Compared with the combined imaging,the statistical results had a statistical difference( χ2= 4. 18,P < 0. 05; χ2= 6. 56,P< 0. 05). The sensitivity,specificity and accuracy were 88. 9%,85. 7% and 87. 5% respectively for the elastic 5 grading method of the diagnosis of endometrial disease. The sensitivity,specificity and accuracy were 91. 7%,89. 3% and 90. 6% respectively for the strain rate ratio method of the diagnosis of endometrial disease. It can be seen that the strain rate ratio method is slightly higher than the elastic 5 grading method in terms of sensitivity,specificity and accuracy,and there is no statistical difference between them( P > 0. 05). Conclusion Transvaginal ultrasound elastography has important clinical value in the diagnosis and identification of endometrial diseases.