子宫腺肌病临床病理特征及经阴道三维超声定量测量诊断价值

Clinicopathological features of adenomyosis and diagnostic value of transvaginal three-dimensional ultrasound quantitative measurement

目的:探究子宫腺肌病临床病理特征及经阴道三维超声定量测量的诊断价值。方法:以80例疑似子宫腺肌病患者为研究对象,根据病理或手术结果分为子宫腺肌病组(n=36)、非子宫腺肌病组(n=44)。分析子宫腺肌病患者的临床病理特征,探究经阴道三维超声对子宫腺肌病的诊断价值,比较两组患者三维超声定量指标[血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI)]、血流超声参数[子宫动脉血流量(BFV)、阻力指数(RI)、搏动指数(PI)]水平的差异,使用受试者工作特征(ROC)曲线探究存在统计学差异的上述指标对子宫腺肌病的诊断效能。结果:36例患者经病理或手术结果诊断为子宫腺肌病,子宫腺肌病类型以弥漫性(69.44%)为主,超声征象主要以子宫增大(75.00%)、肌壁线衰减/栅栏状(72.22%)、肌层回声增粗不均匀(63.89%)为主;经阴道三维超声诊断子宫腺肌病的准确率为83.75%,灵敏度为86.11%,特异度为81.82%,阳性预测值为79.49%,阴性预测值为87.80%;子宫腺肌病组VI、FI、VFI、BFV、PI水平均高于非子宫腺肌病组,RI低于非子宫腺肌病组,组间比较差异有统计学意义(均P<0.05);ROC曲线结果显示,VI、FI、VFI、BFV、RI、PI对子宫腺肌病的诊断效能均较高(AUC=0.921、0.768、0.842、0.925、0.788、0.805,均P<0.05)。结论:经阴道三维超声定量测量可客观分析子宫腺肌病血供、血流情况,能为诊断子宫腺肌病提供一定参考价值。

Objective:To explore the clinicopathological features of adenomyosis and the diagnostic value of transvaginal three-dimensional ultrasound quantitative measurement.Methods:A total of 80 patients with suspected adenomyosis were selected as the research subjects.According to pathological or surgical results,the patients were divided into adenomyosis group(36 cases)and non-adenomyosis group(44 cases).The clinicopathological characteristics of patients with adenomyosis were analyzed,and the value of transvaginal three-dimensional ultrasound in the diagnosis of adenomyosis were explored.The three-dimensional ultrasound quantitative indicators[Vascularization Index(VI),Blood Flow Index(FI),Vascularization Flow Index(VFI)]and ultrasound parameters of blood flow[uterine artery blood flow volume(BFV),Resistance Index(RI),Pulsatility Index(PI)]were compared between the two groups.ROC curve was used to explore the diagnostic efficiency of the above indicators with significant differences for adenomyosis.Results:Thirty-six patients were diagnosed with adenomyosis by pathological or surgical results.The type of adenomyosis was mainly diffuse(69.44%),and the ultrasound signs were mainly enlarged uterus(75.00%),muscle wall attenuation/palisade shape(72.22%)and uneven thickening of myometrial echoes(63.89%).The accuracy rate,sensitivity,specificity,positive predictive value and negative predictive value of transvaginal three-dimensional ultrasound in the diagnosis of adenomyosis were 83.75%,86.11%,81.82%,79.49%and 87.80%.The VI,FI,VFI,BFV and PI of the adenomyosis group were higher than those of the non-adenomyosis group,while the RI was lower than that of the non-adenomyosis group(all P<0.05).ROC curve results showed that VI,FI,VFI,BFV,RI and PI had high diagnostic efficiency for adenomyosis(AUC=0.921,0.768,0.842,0.925,0.788,0.805,all P<0.05).Conclusion:Transvaginal three-dimensional ultrasound quantitative measurement can objectively analyze the blood supply and blood flow of adenomyosis,and can provide a certain reference value for the diagnosis of adenomyosis.