三维能量多普勒联合宫腔声学造影在宫腔内良性病变中的应用价值

Value of Three-Dimensional Power Doppler Angiography Combined with Sonohysterography in the Diagnosis of Intrauterine Benign Lesions

目的运用0.9%氯化钠注射液宫腔声学造影(saline infusion sonohysterography,SIS)技术诊断宫腔内良性病变,并联合三维能量多普勒(three-dimensional power doppler angiography,3D-PDA)定量分析,探讨其对病变的诊断及鉴别诊断的能力。方法二维阴道超声(transvaginal ultrasonography,TVS)初步筛查提示宫腔内良性病变的90例患者作为本项研究的对象,进行0.9%氯化钠注射液宫腔声学造影,并运用VOCAL软件系统获得病灶的相关容积血流参数。结果 SIS对宫腔内病变有较高的诊断价值,90例患者中诊断为内膜息肉21例,黏膜下肌瘤45例,内膜增生17例,血凝块7例,共误诊2例。通过SIS联合三维能量多普勒分析子宫内膜息肉组与黏膜下肌瘤组血流信息,两组的VI、FI和VFI比较,差异有统计学意义(P<0.05),对两者鉴别有诊断意义。结论生理盐水宫腔声学造影对宫内良性病变具有很高的诊断符合率、敏感度及特异性,结合三维能量多普勒定量分析更加能清晰地显示病灶的血流灌注类型,为临床制定最佳治疗方案提供有价值的诊断信息。

Objective To investigatethe value of saline infusion sonohysterography(SIS) combined with quantitative analysis of three- dimensional power doppler in the diagnosis and differential diagnosis of benign intrauterine lesions.Methods In this study,90 cases with transvaginal ultrasonography(TVS) prompting intrauterine occupying lesions were carried on SIS.We can use the VOCAL software system to obtain the focus of the relevant volume of blood flow parameters.Results In 90 patients,there were 21cases of endometrial polyps,45 cases of submucosal fibroids,17 case of intimal hyperplasia and 7 cases of blood clots,2 cases of misdiagnosis.The blood flow information of the endometrial polyp group and submucosal myoma group was analyzed by SIS combined with three-dimensional energy doppler,which has diagnostic significance to distinguish between the two.And the differences in VI,FI,and VFI between the two groups were statistically siginificant( P <0.05).Conclusion SIS has higher accuracy,specificity and sensitivity in diagnosis of intrauterine benign lesions.Three-dimensional power doppler combined with quantitative analysis can clearly show the lesions perfusion.It can provide valuable diagnostic informations for making the best treatment plan for the clinic.