腹部彩色多普勒超声检查对子宫腺肌病与子宫肌瘤的鉴别诊断价值分析

Analysis of the differential diagnostic value of abdominal color Doppler ultrasound used in adenomyosis and uterine fibroids

目的探讨腹部彩色多普勒超声检查对子宫腺肌病与子宫肌瘤的鉴别诊断价值。方法选取2020年1月至2021年1月营口市妇产儿童医院收治的93例疑似子宫腺肌病患者作为子宫腺肌病组,另选取同期93例疑似子宫肌瘤患者作为子宫肌瘤组。两组均行腹部彩色多普勒超声检查,以病理检查为金标准,计算腹部彩色多普勒超声诊断符合率,并记录两组子宫动脉血流参数及超声声图像特征。结果两组腹部彩色多普勒超声诊断符合率比较差异无统计学意义。子宫腺肌病组子宫动脉阻力指数(RI)、子宫动脉搏动指数(PI)均高于子宫肌瘤组,差异有统计学意义(P<0.05);两组子宫动脉收缩期血流速度(PS)、子宫动脉舒张期血流速度(ED)比较差异无统计学意义。子宫腺肌病患者超声声像图特征:病变组织内部见少量点状彩色血流信号,而病变组织附近未见彩色血流信号;子宫内膜模糊或移位;边界模糊;子宫形态大,多无异常改变,且呈弥漫性增大征象;病变组织多以球状感为主,边界十分模糊,且多出现于子宫后壁,回声多为粗颗粒状及网格状,子宫后侧多有细条放射状浅淡声影。子宫肌瘤患者超声声像图特征:内部可见稍高回声或少量等回声,以低回声为主,如病灶体积偏大,内部可见螺旋状回声,且伴多层衰减声影,附近存在声晕,边界较清晰;病灶在子宫任何位置均可能出现;子宫形态出现变化,异常增大;病灶内部有散在点状血流信号,附近有环状或半环状血流束。结论腹部彩色多普勒超声检查技术诊断子宫腺肌病与子宫肌瘤的价值较高。

Objective To investigate the differential diagnostic value of abdominal color doppler ultrasound used in adenomyosis and uterine fibroids.Methods 186 patients with suspected adenomyopathy admitted to Yingkou Maternity and Children's Hospital from January 2020 to January 2021 were selected as the adenomyopathy group,and another 93 patients with suspected uterine fibroids were selected as the uterine fibroid group during the same period.Abdominal color Doppler ultrasonography was performed in both groups,the pathological examination was used as the gold standard to calculate the diagnostic coincidence rate of abdominal color Doppler ultrasonography,and the parameters of uterine artery blood flow and ultrasonic image characteristics were recorded between the two groups.Results There was no significant difference in the diagnosis coincidence rate of abdominal color Doppler ultrasound between the two groups.The resistance index(RI)and pulsatility index(PI)of uterine artery in the adenomyosis group were higher than those in the uterine myoma group,and the differences were statistically significant(P<0.05);there were no significant differences in peak systolic(PS)and end diastolic(ED)of uterine artery between the two groups.Ultrasonographic features of patients with adenomyopathy:the small number of dot color blood flow signals were seen in the diseased tissue,but no color blood flow signals were seen near the diseased tissue.Blurred or displaced endometrium;the boundary is fuzzy;the uterus was large in shape,mostly without abnormal changes,and showed signs of diffuse enlargement,most of the pathological tissues were spherical,the boundary was very vague,and most of them appeared in the posterior wall of the uterus,the echoes were mostly coarse grain and grid,and the posterior side of the uterus was mostly thin radial sound shadow.Ultrasonic image characteristics of patients with uterine fibroids:slightly high echo or a small amount of isoecho can be seen inside,mainly low echo.For example,the size of the lesion is large,spiral echo can be seen inside,accompanied by multi-layer attenuation sound shadow,there is the sound halo nearby,and the boundary is clear.Lesions can occur anywhere in the uterus.Uterine morphology changes,abnormal enlargement;there were scattered punctated blood flow signals inside the lesion and annular or semi-annular blood flow tracts nearby.Conclusion Abdominal color Doppler ultrasonography is of high value in the diagnosis of adenomyopathy and uterine myoma.