经阴道超声联合彩色多普勒能量图应用于子宫内膜息肉及子宫黏膜下肌瘤诊断分析

Application of transvaginal ultrasonography combined with color Doppler energy imaging in diagnostic analysis of endometrial polyp and uterine submucous myoma

目的探讨经阴道超声联合彩色多普勒能量图应用于子宫内膜息肉及子宫黏膜下肌瘤的诊断价值。方法选择2014年1月～2015年9月在我院就诊的子宫内膜息肉患者53例,子宫黏膜下肌瘤患者66例,采用单纯经阴道超声诊断及经阴道超声联合彩色多普勒能量图诊断,并与金标准诊断进行比较,分析子宫内膜息肉及子宫黏膜下肌瘤超声诊断鉴别特征。结果经阴道超声联合彩色多普勒能量图对子宫内膜息肉及子宫黏膜下肌瘤诊断灵敏度、特异度、准确率均明显高于单纯经阴道超声诊断（P〈0.05）,经阴道超声联合彩色多普勒能量图对子宫黏膜下肌瘤及子宫黏膜下肌诊断Youden指数、Kappa值均较单纯经阴道超声诊断明显提高,Kappa值均≥0.75。子宫内膜息肉及子宫黏膜下肌瘤肿块大小、形态、显像内膜夹角、病灶内回声、病灶周边声晕、病灶内血流信号特征等比较差异有统计学意义（P〈0.05）。结论经阴道超声联合彩色多普勒能量图诊断子宫内膜息肉及子宫黏膜下肌瘤与病理结果一致性高,可提高子宫内膜息肉及子宫黏膜下肌瘤诊断和鉴别诊断效能。

Objective To discuss the application value of transvaginal ultrasonography（TVUS） combined with color doppler energy（CDE） imaging in diagnostic analysis of endometrial polyp and uterine submucous myoma. Methods A total of 53 patients with endometrial polyp and 66 patients with uterine submucous myoma treated in our hospital from January 2014 to September 2015 were selected. All the patients were diagnosed by simple TVUS and TVUS combined with CDE, and the results were compared with the gold standard. The ultrasonic features of endometrial polyp and uterine submucous myoma were analyzed. Results The sensitivity, specificity, and accuracy rate of TVUS combined with CDE in diagnosis of endometrial polyp and uterine submucous myoma were all significantly higher than those of simple TVUS（P〈0.05）. The Youden index and Kappa value of TVUS combined with CDE in diagnosis of endometrial polyp and uterine submucous myoma were all significantly higher than those of simple TVUS, and Kappa values in both groups were not lower than 0.75. The comparative differences in size, shape, included angle of imaging endometrium, echo in lesion, echo halo around lesion, and blood flow signal in lesion of endometrial polyp and uterine submucous myoma were statistically significant（P〈0.05）. Conclusion Application of TVUS combined with CDE in diagnosis of endometrial polyp and uterine submucous myoma has high consistency with pathological examination, which can enhance the efficiency of diagnosis and differential diagnosis of endometrial polyp and uterine submucous myoma.