经阴道三维超声对子宫内膜癌肌层浸润的诊断价值

The Role of Three-dimensional Transvaginal Sonography in the Evaluation of Myometrial Invasion of Endometrial Carcinoma

目的探讨经阴道三维超声对子宫内膜癌肌层浸润的诊断价值。方法随机抽取63例经诊断性刮宫确诊并进行手术治疗的子宫内膜癌患者的临床资料。对患者进行阴道三维超声评估。观察三维超声多平面成像图像特征、三维超声多平面成像诊断肌层浸润结果、三维超声下子宫体积、肿瘤体积诊断肌层浸润结果、三维超声诊断深肌层浸润的敏感性、特异性。结果三维超声多平面成像法诊断浅肌层浸润的准确性较高,和二维超声比较,差异有统计学意义(P<0.05)。三维超声多平面成像法诊断深肌层浸润的准确性,和二维超声比较,差异无统计学意义(P>0.05)。不同肌层浸润深度肿瘤体积比较,差异有统计学意义(P<0.05)。不同肌层浸润深度子宫体积比较,差异无统计学意义(P>0.05)。三维超声和二维超声诊断深层肌层浸润的敏感性、特异性比较,差异无统计学意义(P>0.05)。结论经阴道三维超声对子宫内膜癌肌层浸润有一定的诊断价值,对于诊断浅肌层浸润的准确性较高,肿瘤体积可作为肌层浸润深度的诊断依据。

Objective To explore the role of three-dimensional transvaginal sonography in the evaluation of myometrial invasion of endometrial carcinoma. Methods 63 cases of patients with endometrial adenocarcinoma confirmed by diagnostic cu- rettage and treated by operation were selected. The patients received three-dimensional transvaginal sonography. The three-dimen- sional ultrasound multiplanar imaging characteristics, three-dimensional ultrasound multiplanar imaging in the diagnosis of muscu- lar layer infiltration results, under three-dimensional ultrasound volume of uterus, tumor volume in the diagnosis of muscular layer infiltration, the sensitivity and specificity of myometrial invasion by three-dimensional ultrasound were analyzed. Results The ac- curacy of shallow muscular infiltration diagnosis by three-dimensional ultrasound multiplanar imaging method were higher than two-dimensional ultrasound（ P 〈0, 05 ） ;There had no significant difference in the accuracy of deep muscle layer infiltration（ P 〉 O. 05 ） ;There had significant difference in the tumor Yolume at different muscular infiltration depth（ P 〈 0.05 ） ;There had no sig- nificant difference in the uterine volume （P 〉 0.05 ） ;There had no significant difference in the sensitivity, specificity （P 〉 0.05 ）. Conclusion Three-dimensional transvaginal sonography has diagnostic value for myometrial invasion of endometrial adenoearci- noma, it has high accuracy of diagnosis of shallow layer infiltration, and tumor volume can be used as the diagnosis basis of muscu- lar layer infiltration depth.