深部浸润性子宫内膜异位症的经阴道三维容积超声、MRI影像特征及应用价值

aracteristics and application value of transvaginal three-dimensional volumetric ultrasound MRI in deep invasive endometriosis

目的 研究深部浸润性子宫内膜异位症(DIE)的经阴道三维容积超声、磁共振成像(MRI)影像特征及应用价值。方法 回顾分析2019年1月至2021年1月来我院就诊的疑似深部浸润性DIE30例患者的临床资料。将其经阴道三维容积超声、MRI诊断结果与病理检查结果做对照,分析经阴道三维容积超声、MRI的诊断价值,并对深部浸润性DIE的经阴道三维容积超声、MRI影像特征进行分析。结果 累及直肠陷窝DIE经三维容积超声及MRI诊断准确率分别为80.00%、73.33%,累及子宫骶骨韧带DIE经三维容积超声及MRI诊断准确率分别为86.67%、83.33%,累及直肠DIE经三维容积超声及MRI诊断准确率分别为76.67%、88.67%,累及阴道直肠膈DIE经三维容积超声及MRI诊断准确率分别为96.67%、90.00%,累及穹窿阴道壁经三维容积超声及MRI诊断准确率分别为90.00%、83.33%。结论 对于累及子宫骶骨韧带等子宫特殊结构的DIE,应用阴道三维容积超声的诊断效能更高,而对于累及尿道等盆腔内脏器结构的DIE,应用MRI的诊断效能更高,临床应根据患者实际情况选择影像学检查策略,必要时可联合两种方法进行诊断。

Objective To study the characteristics and application value of transvaginal three-dimensional volume ultrasound and magnetic resonance imaging(MRI) in deep invasive endometriosis(DIE). Methods The clinical data of 30 patients with suspected deep invasive DIE who came to our hospital from January 2019 to January 2021 were retrospectively analyzed. The diagnostic results of transvaginal three-dimensional volume ultrasound and MRI were compared with the results of pathological examination to analyze the diagnostic value of transvaginal three-dimensional volume ultrasound and MRI, and the imaging characteristics of deep invasive DIE were analyzed. Results The diagnostic accuracy rates of DIE involving the rectal lacuna by three-dimensional volume ultrasound and MRI were 80.00% and 73.33%, respectively, and the diagnostic accuracy of DIE involving the uterosacral ligament by three-dimensional volume ultrasound and MRI were 86.67% and 83.33%, respectively. The diagnostic accuracy rates of volume ultrasound and MRI were 76.67% and 88.67%, respectively. The diagnostic accuracy rates of DIE involving the vagina and rectal diaphragm were 96.67% and 90.00%, respectively, and the diagnostic accuracy rates of the vaginal wall involving the fornix were 3D volume ultrasound and MRI. They were 90.00% and 83.33%, respectively. Conclusion For DIE involving special structures of the uterus such as the uterosacral ligament, the application of vaginal three-dimensional volume ultrasound has a higher diagnostic efficiency, while for DIE involving the urethra and other pelvic viscera structures, the application of MRI has a higher diagnostic efficiency. The clinical situation should be based on the actual situation of the patient. The imaging strategy is selected, and the two methods can be combined for diagnosis if necessary.