超声造影定量指标在鉴别子宫内膜增生不同病理分型中的应用价值

The value of quantitative parameters of contrast-enhanced ultrasound in evaluation of different pathological types of endometrial hyperplasia

目的探讨超声造影在子宫内膜增生不同病理分型定量评估中的应用价值。方法选择2016年1~10月在南京中医药大学附属医院妇科拟诊为子宫内膜增生(endometrial hyperplasia,EH)的病例50例,在行诊断性刮宫前行子宫内膜超声造影检查,获取时间-强度曲线(time-intensity curve,TIC),分别采集峰值强度(peak time,PI)、平均渡越时间(mean transit time,MTT)、曲线下面积(area under the curve,AUC)、峰值减半时间(time from peak to one half,TPH)、内洗斜率(wash in slope,WIS)、达峰时间(time to peak,TTP),并将内膜的参数和肌层的参数做比值。按照病理结果纳入病例共40例,分为3组:单纯性增生(simple hyperplasia,SH)组23例,复杂性增生(complex hyperplasia,CH)组10例,非典型增生(atypical hyperplasia,AH)组7例。比较3组内膜和肌层的PI比、MTT比、AUC比、TPH比、WIS比、TTP比。结果 SH、CH、AH 3组内膜和肌层的PI比、AUC比、WIS比两两比较,差异有统计学意义(P<0.05),而MTT比、TPH比、TTP比差异无统计学意义(P>0.05)。结论子宫内膜超声造影在定量评估子宫内膜增生的不同病理分型中有一定价值。

Objective To explore the value of quantitative parameters of contrast - enhanced ultrasound （CEUS） in the evaluation of different pathological types of endometrial hyperplasia. Methods Fifty cases suspected as endometrial hyperplasia （EH） were selected from Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January to October 2016. All underwent CEUS before diagnostic curettage in order to get the time - intensity curve （ TIC ） of endometrium and myometrium, separately. Then gathered the PI, MTT, AUC, TPH, WIS,TTP of endometrium and myometrium from TICs and got the ratio of these two set of data. 40 cases were included according to pathological findings and were divided into 3 groups： simple hyperplasia （SH） group （23 cases）, complex hyperplasia （CH） group（10 cases） and atypical hyperplasia （AH） group（7 cases）. The PI ratio, MTT ratio, AUC ratio, TPH ratio, WIS ratio and TTP ratio of endometrium and myometrium were compared between the 3 groups. Results PI ratio, AUC ratio and WIS ratio of the 3 groups were statistically different （ P 〈 0. 05 ）, while MTF ratio, TPH ratio and TFP ratio were not statistically different（P 〉 0. 05 ）. Conclusion Endometrial ultrasonography is of some value in quantitative evaluation of different pathological types of endometrial hyperplasia.