静脉超声造影对子宫腺肌症和子宫肌瘤的鉴别诊断价值

Value of Intravenous Contrast-enhanced Ultrasound in Differential Diagnosis of Adenomyosis and Uterine Fibroids

目的探讨静脉超声造影对子宫腺肌症和子宫肌瘤的鉴别诊断价值。方法对2017年12月至2019年12月就诊于昆明医科大学第一附属医院妇产科133例子宫肌瘤和子宫腺肌症的患者实施常规超声检查及静脉超声造影检查;与术后病理检查结果对照,对比常规超声与静脉超声造影检查之间的准确性差异,分析子宫肌瘤与子宫腺肌病之间的超声影像学特点。结果(1)常规超声、超声造影诊断子宫肌瘤的准确率分别为92%,98%,二者差异有统计学意义(P<0.05);诊断子宫腺肌症的准确率分别为91%,100%,二者差异有统计学意义(P<0.05);(2)静脉超声造影检查,子宫腺肌症患者开始时间早于子宫腺肌瘤患者,达峰时间早于子宫肌瘤患者,峰值强度低于子宫肌瘤患者,差异有统计学意义(P<0.05)。结论(1)静脉超声造影在子宫腺肌症与子宫肌瘤的诊断中优于常规超声检查;(2)子宫腺肌症与子宫肌瘤在超声造影检查中有各自不同特征性改变,可作为鉴别两者的要点。

Objective To evaluate the differential diagnosis of uterine adenomyosis and uterine fibroids by intravenous contrast-enhanced ultrasound(CEUS).Methods Routine ultrasonography and intravenous CEUS were performed in patients with uterine fibroids and adenomyosis in the department of obstetrics and gynecology,the First Affiliated Hospital of Kunming Medical University from December 2017 to December 2019.The results of postoperative pathological examination were compared,the accuracy of conventional ultrasound and intravenous CEUS was analyzed,and the characteristics of CEUS for uterine fibroids and adenomyosis were also analyzed.Results 1.The accuracy rates of conventional ultrasound and CEUS in the diagnosis of uterine fibroids were 92%and 98%,respectively,with statistically significant differences(P<0.05).The accuracy of adenomyosis diagnosis was 91%and 100%,respectively,with statistically significant difference(P<0.05).2.According to intravenous contrast-enhanced ultrasonography,the onset time of adenomyosis was earlier than that of adenomyoma,and the peak time was earlier than that of uterine fibroids,and the peak intensity was lower than that of uterine fibroids,with statistically significant difference(P<0.05).Conclusions 1.Intravenous CEUS is superior to conventional ultrasonography in the diagnosis of adenomyosis and uterine fibroids.2.Adenomyosis and hysteromyoma have different characteristic changes in contrast-enhanced ultrasonography,which can be used as the key point to differentiate them.