超声鉴别诊断子宫肌瘤及子宫腺肌病的临床价值研究

Clinical value of ultrasound in differential diagnosis of uterine fibroids and adenomyosis

目的探究应用超声鉴别诊断子宫肌瘤与子宫腺肌病的临床价值。方法回顾性分析2018年8月至2020年8月本院收治的43例子宫肌瘤患者(子宫肌瘤组)与57例子宫腺肌病(子宫腺肌病组)患者的临床资料。两组患者均接受腹部彩超联合阴道彩超检查,比较两组阻力指数、血流搏动指数和Adler分级。以病理结果作为金标准,分析超声检查对子宫肌瘤和子宫腺肌病的诊断准确率。结果子宫肌瘤组搏动指数、阻力指数均低于子宫腺肌病组,差异有统计学意义(P<0.05)。子宫肌瘤组患者Adler分级0级、Ⅰ级占比低于子宫腺肌病组,Ⅱ级、Ⅲ级占比高于子宫肌腺病组,差异均有统计学意义(P<0.05)。两组腹部超声联合阴道超声诊断准确率高于单纯腹部超声,差异有统计学意义(P<0.05);两组腹部超声联合阴道超声诊断准确率与单纯阴道超声检查比较差异无统计学意义。结论腹部超声联合阴道超声对子宫肌瘤和子宫腺肌病诊断准确率高于单纯超声检查,血流搏动指数、阻力指数和Adler分级可作为子宫肌瘤与子宫腺肌病超声鉴别诊断的重要标准。

Objective To explore the clinical value of ultrasound in the differential diagnosis of hysteromyoma and adenomyosis.Methods The clinical data of 43 patients with hysteromyoma(hysteromyoma group)and 57 patients with adenomyosis(adenomyosis group)treated in our hospital from August 2018 to August 2020 were retrospectively analyzed.Both groups were examined by abdominal color Doppler ultrasound combined with vaginal color Doppler ultrasound.The resistance index,blood flow pulsatility index and Adler grade between the two groups were compared.The diagnostic accuracy of ultrasound in hysteromyoma and adenomyosis were analyzed with pathological results as the gold standard.Results The pulsatility index and resistance index of hysteromyoma group were lower than those of adenomyosis group,the difference was statistically significant(P<0.05).The proportion of Adler grade 0 and grade I in hysteromyoma group was lower than that in adenomyosis group,while the proportion of Adler grade II and grade III in hysteromyoma group were higher than the adenomyosis group,and the difference was statistically significant(P<0.05).The diagnostic accuracy of abdominal ultrasound combined with vaginal ultrasound in both groups were higher than the simple abdominal ultrasound,and the difference was statistically significant(P<0.05).There was no significant difference in diagnostic accuracy between abdominal ultrasound combined with vaginal ultrasound and vaginal ultrasound alone in the two groups.Conclusion The diagnostic accuracy of abdominal ultrasound combined with transvaginal ultrasound in uterine fibroids and adenomyosis is higher than that of ultrasound alone.Pulsatility index,resistance index and Adler grade can be used as important criteria for the differential diagnosis of uterine fibroids and adenomyosis.