经阴道彩色多普勒超声联合弹性成像在子宫恶性肿瘤早期诊断中的临床应用分析

Clinical Application of Transvaginal Color Doppler Ultrasound Combined with Elastography in Early Diagnosis of Uterine Malignant Tumors

目的探讨经阴道彩色多普勒超声联合弹性成像在子宫恶性肿瘤早期诊断中的应用效果。方法将80例经手术病理确诊为早期子宫恶性肿瘤患者作为研究对象,将其按照诊断方案的不同随机分成对照组(n=26)、试验组1(n=27)、试验组2(n=27)。对照组采用单一经阴道彩色多普勒超声诊断,试验组1采用单一超声弹性成像诊断,试验组2采用经阴道彩色多普勒超声联合弹性成像诊断,比较3组患者的诊断准确性和病理检查结果,对不同分期患者的相关指标进行对比。结果试验组2的诊断准确性92. 6%明显高于对照组的诊断准确性80. 8%与试验组1的诊断准确性77. 8%。ⅠA期患者的子宫内膜厚度、血液显示率及阻力指数均明显低于ⅠB期患者。单一阴道超声早期诊断子宫恶性肿瘤的符合率为61. 5%,在浅肌层浸润中的灵敏度为40%、在深肌层浸润中的灵敏度为66. 7%;单一超声弹性成像诊断子宫恶性肿瘤的符合率为70. 4%,在浅肌层浸润中的灵敏度为55. 6%、在深肌层极润中的灵敏度为66. 7%;经阴道彩色多普勒超声联合弹性成像诊断子宫恶性肿瘤的符合率为81. 5%,在浅肌层浸润中的灵敏度为80%、在深肌层浸润中的灵敏度为66. 7%。结论子宫恶性肿瘤越早期患者的临床指标越不明显,经阴道彩色多普勒超声联合弹性成像早期诊断子宫恶性肿瘤的准确度较高,且有助于肌层浸润的判定,具有较高的临床应用价值。

Objective To evaluate the effect of transvaginal color Doppler ultrasound combined with elastography in the early diagnosis of uterine malignant tumors. Methods 80 cases of early malignant uterine tumors diagnosed by surgery and pathology were selected as research subjects. They were randomly divided into the control group( n = 26),test group 1( n = 27) and test group 2( n = 27),according to different diagnostic plans. The control group was diagnosed by single transvaginal color Doppler ultrasound,1 in the test group was diagnosed by single ultrasound elastography,and 2 in the test group was diagnosed by transvaginal colored Doppler ultrasound combined with elastic imaging. The diagnostic accuracy and pathological results of the 3 groups were compared and the related indexes of the patients in different stages were compared. Results The diagnostic accuracy of the experimental group 2 was 92. 6%,significantly higher than that of the control group 80. 8%,and the diagnostic accuracy of the experimental group 1 was 77. 8%. The endometrial thickness,blood display rate and resistance index of patients with stage ⅠA were significantly lower than those of stage ⅠB patients. The coincidence rate of early diagnosis of uterine malignant tumors by single vaginal ultrasound was 61. 5%,the sensitivity in the infiltration of the superficial myometrium was 40%,the sensitivity in the deep myometrium infiltration was 66. 7%,the coincidence rate of the single ultrasound elastography in the diagnosis of uterine malignant tumors was 70. 4%,the sensitivity in the superficial myometrium infiltration was 55. 6%,and the spirit in the deep muscular layer was extremely moist. Sensitivity was 66. 7%;the coincidence rate of transvaginal color Doppler ultrasound combined with elastography in the diagnosis of malignant uterine tumors was 81. 5%. The sensitivity in the infiltration of the superficial myometrium was 80% and the sensitivity in the deep myometrium infiltration was 66. 7%. Conclusion The early diagnosis of uterine malignant tumor is less obvious. The accuracy of early diagnosis of uterine malignant tumor by transvaginal colored Doppler ultrasound combined with elastography is higher,and it was helpful for the determination of myometrium infiltration,which has high clinical value.