不同年龄组子宫内膜癌经静脉超声造影特点研究

Research of Intravenous Contrast-enhanced Ultrasound characteristics of Endometrial Carcinoma by Transvaginal examination between Premenopausal and Postmenopausal Women

目的探讨子宫内膜癌在不同年龄组患者中经静脉超声造影特点。方法采用经阴道实时静脉超声造影技术对术后病理证实为子宫内膜癌的74例患者按年龄分组进行超声造影灌注特点及TIC曲线各参数的对比分析。74例子宫内膜癌患者按照年龄分组,即绝经期女性30例,绝经后女性44例。所有病灶根据以下3个超声造影灌注特点进行观察:增强强度与均度、灌注时相、病灶中心主要供血血管。结果 30例绝经前女性子宫内膜癌中,在增强强度与均度上表现为均匀高或等增强为主,占24例(24/30,80%);灌注时相上早进早退类型共14例(14/30,46.7%),其他16例;病灶中心主要供血血管表现为病灶中心无粗大可辨认供血血管占25例(25/30,83.3%),其余5例。与绝经后女性内膜癌比较,增强强度与均度、病灶中心主要供血血管这两个特点上分布比较,差异无统计学意义(P>0.05),灌注时相上分布差异具有统计学意义(χ2=4.236,P<0.05);对两组病灶进行TIC曲线分析,两组各参数间比较,差异无统计学意义(P>0.05)。结论绝经前、后女性子宫内膜癌超声造影存在共性,亦有一定的差异,有助于全面认识子宫内膜癌。

Objective To observe the intravenous contrast-enhanced ultrasound（CEUS） characteristics of endometrial carcinoma between premenopausal and postmenopausal women by transvaginal examination（TVS）. Methods Seventy four cases of endometrial carcinoma were grouped according to age which all be confirmed by pathology, which all were evaluated pre-operatively with intravenous CEUS by TVS. The enhancement patterns were observed, and TIC curve of endometrial lesions were compared.Seventy four cases of endometrial carcinoma were divided into two groups：30 cases of premenopausal endometrial carcinoma and 44 cases of postmenopausal endometrial carcinoma. All lesions were observed according to the following features：enhancement intensity and degree of homogeneity, enhancement phases, main vessels in the center of lesion. Results In enhancement intensity and degree of homogeneity, 24 （24/30, 80%） cases of premenopausal endometrial carcinoma appeared hyper-enhancement or iso-enhancement, the other type was only 6 cases （including hypo-enhancement or inhomogeneous enhancement）. In enhancement phases, 14 （14/30, 46.7%） cases of premenopausal endometrial carcinoma rapidly washed in and out, and the other type was 16 cases. The absence of recognizable main vessels in the center of lesion were 25 cases（25/30,83.3%）,the presence of recognizable main vessels in the center of lesions was only 5 cases. There were no significant differences between the two groups in the following two aspects：Enhancement intensity and degree of homogeneity, main vessels in the center of lesion. But in the enhancement phase,there was significant difference between the two groups（χ2=4.236, P〈0.05）.There were no significant differences among the parameters of TIC curve of endometrial lesions between the two groups. Conclusion There were the same characteristics in CEUS between premenopausal and postmenopausal endometrial carcinomas, but also there were some differences between the two groups. CEUS can help us to understand endometrial carcinoma in detail.