阴道超声和腹部超声鉴别诊断子宫肌瘤和子宫腺肌病的价值对比

Comparison of value of transvaginal ultrasonography versus abdominal ultrasonography in differential diagnosis of uterine fibroids and adenomyosis

目的对比分析阴道超声和腹部超声鉴别诊断子宫肌瘤与子宫腺肌病的价值。方法抽取2020年2月至2022年2月解放军联勤保障部队第九八九医院收治的疑似子宫肌瘤/子宫腺肌病患者102例,所有患者均行阴道超声和腹部超声检查,以病理诊断结果为"金标准",比较阴道超声和腹部超声的诊断结果、诊断效能;比较不同疾病患者阴道超声检查的血流参数水平[搏动指数(PI)、阻力指数(RI)、舒张期峰值速度(Vd)、收缩期峰值速度(Vs)]。结果 102例疑似子宫肌瘤/子宫腺肌病患者中,病理诊断确诊为子宫肌瘤74例,子宫腺肌病28例;阴道超声确诊为子宫肌瘤69例,子宫腺肌病33例;腹部超声确诊为子宫肌瘤67例,子宫腺肌病35例。阴道超声诊断灵敏度为91.89%(68/74),特异度为96.43%(27/28),准确度为93.14%(95/102),阳性预测值为98.55%(68/69),阴性预测值为81.82%(27/33),均高于腹部超声的79.73%(59/74)、71.43%(20/28)、77.45%(79/102)、88.06%(59/67)、57.14%(20/35),P均<0.05。子宫肌瘤患者PI、RI、Vd、Vs水平均高于子宫腺肌病患者(P均<0.05)。结论与腹部超声相比,阴道超声诊断子宫肌瘤可提高诊断效能,且子宫肌瘤患者血流参数和子宫腺肌病患者存在显著差异,可为临床诊断提供科学依据。

Objective To compare the value of transvaginal ultrasonography and abdominal ultrasonography in differential diagnosis of uterine fibroids and adenomyosis.Methods A total of 102 patients with suspected uterine fibroids or adenomyosis treated in No.989 Hospital of the Joint Logistic Support Force from February 2020 to February 2022 were selected.All selected patients underwent transvaginal and abdominal ultrasonography.Taking pathological diagnosis results as the gold standard,the diagnostic results and diagnostic efficacy of transvaginal ultrasonography and abdominal ultrasonography were compared.The levels of blood flow parameters including pulsation index(PI),resistance index(RI),diastolic peak velocity(Vd),systolic peak velocity(Vs)detected by transvaginal ultrasonography were compared among patients with different diseases.Results Among the 102 patients with suspected uterine fibroids or adenomyosis,74 cases were diagnosed with uterine fibroids,and 28 cases were diagnosed with adenomyosis by pathological diagnosis;69 cases were diagnosed with uterine fibroids,and 33 cases were diagnosed with adenomyosis by transvaginal ultrasound;67 cases were diagnosed with uterine fibroids,and 35 cases were diagnosed with adenomyosis by abdominal ultrasonography.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of transvaginal ultrasonography(91.89%,68/74;96.43%,27/28;93.14%,95/102;98.55%,68/69;81.82%,27/33)were higher than those of abdominal ultrasonography(79.73%,59/74;71.43%,20/28;77.45%,79/102;88.06%,59/67;57.14%,20/35),all P<0.05.The levels of PI,RI,Vd and Vs in patients with uterine fibroids were higher than those in patients with adenomyosis(all P<0.05).Conclusions Compared with abdominal ultrasonography,transvaginal ultrasonography in the diagnosis of uterine fibroids can improve the diagnostic efficiency,and it has significant difference in blood flow parameters between patients with uterine fibroids and patients with adenomyosis,which can provide a scientific basis for clinical diagnosis.