经阴道联合腹部彩色多普勒超声在诊断与卵巢分界不清的阔韧带肌瘤中的价值及其与MRI的对比分析

Value of transvaginal combined abdominal color Doppler ultrasound in diagnosis of broad ligament myoma whose boundaries were unclear with ovary and the comparison with MRI

目的通过分析与卵巢分界不清的阔韧带肌瘤的影像学特点,总结经阴道联合腹部彩色多普勒超声及盆腔MR在诊断阔韧带肌瘤的准确性及差异性,为临床提供一定的指导。方法选取2017年1月~2018年10月在我院手术且术后经病理学确诊为阔韧带肌瘤的50例患者,术前超声提示包块与卵巢分界不清,对比分析患者术前经阴道联合腹部彩色多普勒超声及盆腔MRI+增强的影像学特点,并进行误诊病例分析。结果超声诊断准确率为74%(37/50),与盆腔MR的84%(42/50)比较,差异无统计学意义(P>0.05);超声误诊为卵巢肿瘤10例(20%),MRI误诊为卵巢肿瘤5例(10%),两者比较差异无统计学意义(P>0.05)。结论经阴道联合腹部彩色多普勒超声可通过多方位观察肿瘤的部位、与卵巢的关系、血流情况及走向等诊断阔韧带肌瘤,其诊断准确率与盆腔MRI+增强相近。而盆腔MRI可弥补超声检查中因肥胖、肠气等因素干扰的影响,且具有分辨肿瘤良恶性、与周围组织关系等优势,两者联合检查对提高诊断率及指导妇科手术方案有较大的帮助。

Objective By analyzing the imaging characteristics of broadband ligament myoma whose boundaries were unclear with ovary,summarize the difference of ultrasound and MRI in diagnosis of broadband ligament myoma to help for clinical.Methods A total of 50 patients whose pathological diagnosis of broadband ligament myomas in our hospital from January 2017 to October 2018,the ultrasounds showed that the boundaries were unclear with ovaries.To analyze imaging characteristics of color Doppler ultrasound and MR,in addition to analyze the misdiagnosis cases.Results The accuracy rate of Ultrasound was 74%(37/50),MRI was 84%(42/50),there were no statistical difference between the two groups(P>0.05).10 cases(20%)misdiagnosed as ovarian tumors by ultrasound.5 cases(10%)misdiagnosed as ovarian tumors by MR.There were no statistical difference between the two groups(P>0.05).Conclusion Ultrasound can diagnosed broadband ligament myoma by observing the location of the tumor,the relationship with ovary,blood flow and its trend,etc.The diagnostic accuracy is similar to the pelvic MR.Pelvic MRI could compensated for the interference of obesity,intestinal gas and other factors.It has the advantages of distinguishing benign from malignant tumors and the relationship with surrounding.The combined examination of the two methods can improved the diagnostic.It is helpful to guide gynecological operation plan.