超声及血流参数在子宫内膜病变中的临床应用价值

Ultrasound and flow parameters in clinical use of endometrial lesions

目的探讨经阴道超声及血流信号参数对子宫内膜恶性病变的临床应用价值。方法回顾性选取长沙市第三医院2017年4月至2022年4月收治的80例疑似子宫内膜恶性病变患者资料,均接受病理检测和经阴道超声检查,分析经阴道超声对子宫内膜恶性病变的诊断效能。结果病理检查确诊良性病变52例,恶性病变28例;经阴道超声将1例子宫内膜息肉和1例内膜增生误诊恶性病变,2例子宫内膜样癌误诊为内膜息肉,检测灵敏度为92.86%(26/28),特异度为96.15%(50/52),准确性为95.00%(76/80)。根据Kappa一致性检验,经阴道超声与病理检测结果一致性较好(Kappa=0.890)。子宫内膜恶性病变患者的子宫内膜厚度明显高于良性组,RIen明显低于良性组,组间差异有统计学意义(P<0.05)。子宫内膜厚度和RIen对子宫内膜恶性病变具有一般诊断效能,而两组联合检测具有较高诊断效能,联合诊断的AUC、约登指数、灵敏度、特异度、95%CI分别为0.893、0.713、96.10%、75.20%、0.879~0.907。结论经阴道超声参数辅以动脉血流信号参数对子宫内膜良恶性病变具有较高的诊断效能。

Objective To investigate the clinical value of transvaginal ultrasonography and flow signal parameters for endometrial malignant lesions.Methods Data of 80 patients with suspected endometrial malignant lesions admitted to the Third Hospital Changsha from April 2017 to April 2022 were retrospectively selected,and all underwent pathological tests and transvaginal ultrasound examination.The diagnostic efficacy of transvaginal ultrasound on malignant endometrial lesions by the pathological test results were analyzed.Results 52 benign lesions and 28 malignant lesions were confirmed by pathological examination.1 case of endometrial polyp and 1 case of endometrial hyperplasia were misdiagnosed as malignant lesions,and 2 cases of endometrial polyp were misdiagnosed as endometrial hyperplasia by transvaginal ultrasound.The detection sensitivity was 92.86%(26/28),specificity was 96.15%(50/52),and accuracy was 95.00%(76/80).According to Kappa consistency test,the results of transvaginal ultrasound and pathological examination were in good agreement(Kappa=0.890).The endometrial thickness of patients with malignant endometrial lesions was significantly higher than that of the benign group,and RIen was significantly lower than that of the benign group,with statistical significance(P<0.05).Endometrial thickness and RIen had general diagnostic efficacy for malignant endometrial lesions,while the two groups had high diagnostic efficacy.AUC,Youden index,sensitivity,specificity,95%CI were 0.893,0.713,96.10%,75.20%,0.879~0.907,respectively.Conclusion Transvaginal ultrasound parameters supplemented by arterial blood flow signal parameters have high diagnostic coincidence rate for benign and malignant endometrial lesions of malignant lesions.