超声弹性成像技术联合宫腔镜对子宫宫腔病变的诊断价值

Diagnostic Value of Ultrasound Elastography Combined with Hysteroscopy for Uterine Cavity Lesions

目的探讨与分析超声弹性成像技术联合宫腔镜对子宫宫腔病变的诊断价值。方法选择2020年4月—2022年12月在淄博市妇幼保健院诊治的87例子宫宫腔病变患者作为研究对象,所有患者都给予超声弹性成像技术联合宫腔镜检查,并给予病理检查并判断诊断价值。结果在87例患者中,病理诊断为子宫内膜癌17例(恶性组);子宫内膜息肉32例,子宫内膜炎18例,子宫黏膜下肌瘤16例,子宫内膜不典型增生4例(良性组)。恶性组的超声弹性成像技术评分明显高于良性组,差异有统计学意义(P<0.05),判断为恶性病变14例,良性病变73例。宫腔镜诊断为子宫内膜癌13例,子宫内膜息肉33例,子宫内膜炎19例,子宫黏膜下肌瘤17例,子宫内膜不典型增生5例,宫腔镜检查总准确率为90.8%(79/87)。超声弹性成像技术联合宫腔镜判断为恶性病变16例,良性病变71例。超声弹性成像技术、宫腔镜、超声弹性成像技术联合宫腔镜鉴别诊断子宫宫腔病变良恶性的敏感性分别为82.3%(14/17)、64.7%(11/17)、94.1%(16/17),特异性分别为100.0%(70/70)、97.1%(68/70)、100.0%(70/70),超声弹性成像技术联合宫腔镜鉴别诊断子宫宫腔病变良恶性的敏感性高于宫腔镜检查,差异有统计学意义(P<0.05),其他方法的诊断敏感性与特异性比较,差异无统计学意义(P>0.05)。结论超声弹性成像技术联合宫腔镜对子宫宫腔病变组织良恶性的判断具有更高的敏感性与特异性,有较好的应用价值。

Objective To explore and analysis the diagnostic values of ultrasonic elastography combined with hysteroscopy for uterine cavity lesions.Methods From April 2020 to December 2022,87 cases of patients with uterine cavity lesions who were diagnosed and treated at Zibo Maternal and Child Health Hospital were selected as the research subjects.All patients were underwent ultrasonic elastography combined with hysteroscopy,and pathological examination were performed to determine the diagnostic value.Results The pathological diagnosis were endometrial cancer in 17 cases(malignant group),endometrial polyps in 32 cases,endometritis in 18 cases,submucosal fi broids in 16 cases,and atypical endometrial hyperplasia in 4 cases(benign group)in the 87 cases.The ultrasound elastography score of the malignant group were signifi cantly higher than that of the benign group(P<0.05),with 14 cases diagnosed as malignant and 73 cases as benign.Hysteroscopy diagnosed 13 cases of endometrial cancer,33 cases of endometrial polyps,19 cases of endometritis,17 cases of submucosal fi broids,and 5 cases of atypical endometrial hyperplasia.The overall accuracy of hysteroscopy were 90.8%(79/87).The combination of ultrasonic elastography and hysteroscopy identified 16 cases of malignant lesions and 71 cases of benign lesions.The sensitivity of ultrasonic elastography,hysteroscopy,and the combination of ultrasonic elastography and hysteroscopy in differential diagnosis of benign and malignant uterine cavity lesions were 82.3%(14/17),64.7%(11/17),and 94.1%(16/17),respectively,with specifi city of 100.0%(70/70),97.1%(68/70),and 100.0%(70/70).The sensitivity of ultrasonic elastography combined with hysteroscopy in diff erential diagnosis of benign and malignant uterine cavity lesions were higher than that of hysteroscopy(P<0.05).There were no significant difference in the diagnostic sensitivity and specificity of other methods(P>0.05).Conclusion Ultrasound elastography combined with hysteroscopy has higher sensitivity and specifi city in the diagnosis of benign and malignant uterine cavity lesions,and has better application value.