3.0T MRI联合经阴道超声弹性成像技术在子宫肌瘤及子宫腺肌病诊断中的应用价值

Application value of 3.0T MRI combined with transvaginal ultrasound elastography technique in diagnosing uterine fibroids and adenomyosis

目的:探讨3.0T核磁共振成像(MRI)联合经阴道超声弹性成像技术在子宫肌瘤及子宫腺肌病诊断中的应用价值。方法:回顾性分析2021年1月至2022年1月期间华北医疗健康集团峰峰总医院收治的56例子宫肌瘤和41例子宫腺肌病患者,所有患者均行3.0T MRI检查和经阴道超声弹性成像技术检查,以病理诊断为“金标准”,比较MRI、经阴道超声弹性成像技术和两者联合的诊断结果,记录不同检查方法的诊断情况,并分析总符合率,计算灵敏度、特异度和准确率。结果:3.0T MRI联合经阴道超声弹性成像检查子宫肌瘤的诊断总符合率为96.43%,MRI诊断的总符合率为75.00%,经阴道超声诊断的总符合率为80.36%,联合、单独检测的总符合率差异均有统计学意义(x^(2)=10.500、7.049,P<0.05);MRI联合经阴道超声弹性成像检查子宫腺肌病的诊断总符合率为97.56%,显著高于MRI(78.05%)和经阴道超声弹性成像(78.05%)单独检查,差异有统计学意义(x^(2)=7.289、7.289,P<0.05);MRI、超声阴道弹性成像技术单独检测及联合检测子宫肌瘤的灵感度分别为71.74%、78.26%及95.62%,特异度分别为90.00%、90.00%及100.00%,准确率分别为75.00%、80.36%及96.43%,其灵敏度及准确率联合检测明显高于MRI单独检测(x^(2)=5.029、10.500,P<0.05),联合检测的准确率明显高于阴道超声单独检测(x^(2)=7.049,P<0.05);MRI、超声阴道弹性成像技术单独检测及联合检测子宫腺肌病的灵感度分别为81.25%、78.73%及96.88%,特异度分别为66.67%、77.78%及100.00%,准确率分别为78.05%、78.05%及97.56%;联合检测的准确率明显高于MRI和阴道超声单独检测,差异有统计学意义(x^(2)=7.289、7.289,P<0.05)。结论:3.0T MRI联合经阴道超声弹性成像技术在子宫肌瘤及子宫腺肌病中确诊率更高,有较好的诊断价值,能为临床医生治疗提供可靠的参考资料。

Objective:To explore the application value of 3.0T magnetic resonance imaging(MRI)combined with transvaginal ultrasound elastography technique in diagnosing uterine fibroids and adenomyosis.Methods:A retrospective analysis was performed on 56 patients with uterine fibroids and 41 patients with adenomyosis who admitted to Fengfeng General Hospital of North China Medical and Health Group from January 2021 to January 2022.MRI and transvaginal ultrasound elastography were respectively performed on all patients,and pathological diagnosis was taken as the"gold standard".The diagnostic results of MRI,transvaginal ultrasound elastography technique and their combination were compared,and the diagnostic situation of different examination methods were recorded.And then,the total coincidence rate was analyzed,and the sensitivity,specificity and accuracy were further calculated.Results:The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 96.43%in detecting uterine fibroids,and that of MRI was 75.00%,and that of transvaginal ultrasonography was 80.36%.The differences of totally diagnostic coincidence rates among combined detection and single detection were significant(x^(2)=10.500,7.049,P<0.05).The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 97.56%in detecting adenomyosis,which was significantly higher than that(78.05%)of MRI and that(78.05%)of transvaginal ultrasound elastography,and the differences were significant(x^(2)=7.289,7.289,P<0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 71.74%,78.26%and 95.62%in detecting uterine fibroids,and the specificities of them were 90.00%,90.00%and 100.00%,and the accuracies of them were 75.00%,80.36%and 96.43%,respectively.The sensitivity and accuracy of the combined detection were significantly higher than those of single MRI detection(x^(2)=5.029,10.500,P<0.05),respectively.The accuracy of the combined detection was significantly higher than that of the single detection of vaginal ultrasonography(x^(2)=7.049,P<0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 81.25%,78.73%and 96.88%in detecting adenomyosis,and the specificities of them were 66.67%,77.78%and 100.00%,and the accuracies of them were 78.05%,78.05%and 97.56%,respectively.The accuracy of the combined detection was significantly higher than that of single MRI detection(x^(2)=7.289,P<0.05),and the accuracy of the combined detection was significantly higher than that of single detection of vaginal ultrasonography(x2=7.289,P<0.05).Conclusion:The diagnosis rate of MRI combined with transvaginal ultrasound elastography technique is higher for uterine fibroids and adenomyosis,which has better diagnostic value,and can provide reliable reference materials for clinicians in performing treatment.