经阴道与经腹部彩色多普勒超声在子宫肌瘤和子宫腺肌病鉴别诊断中的价值及影像特征分析

Value and imaging feature analysis of transvaginal and transabdominal color Doppler ultrasound in the differential diagnosis of uterine fibroids and adenomyosis

目的分析经阴道和经腹部彩色多普勒超声在鉴别诊断子宫肌瘤、子宫腺肌病中的价值及影像特征分析。方法选取2021年1月至2023年12月赣州市妇幼保健院收治的100例子宫疾病患者作为研究对象,其中子宫肌瘤48例,子宫腺肌病52例,所有患者均接受经阴道与经腹部彩色多普勒超声诊断,分析经阴道与经腹部彩色多普勒超声鉴别诊断子宫肌瘤及子宫腺肌病的价值。结果经腹部联合经阴道彩色多普勒超声诊断符合率高于经腹部彩色多普勒超声,差异有统计学意义(P<0.05);与经阴道彩色多普勒超声诊断符合率比较差异无统计学意义。宫肌瘤阻力指数(RI)、搏动指数(PI)均低于子宫腺肌病,收缩期峰值流速(Vs)慢于子宫腺肌病,舒张期峰值流速(Vd)快于子宫腺肌病,差异有统计学意义(P<0.05)。子宫肌瘤周围环状血流信号,信号集中于浆膜下、黏膜下肌瘤蒂部;子宫腺肌病周围血流信号少,内部星状血流信号。结论经阴道联合经腹部彩色多普勒超声对子宫肌瘤、子宫腺肌病的诊断效果优于单独诊断,且两种疾病的彩色多普勒超声血流信号表现存在显著差异。

Objective To analyze the value and imaging feature of transvaginal and transabdominal color Doppler ultrasound in the differential diagnosis of uterine fibroids and adenomyosis.Methods A total of 100 patients with uterine diseases at Ganzhou Maternal and Child Health Hospital from January 2021 to December 2023 were selected as the study subjects,including 48 cases of uterine fibroids and 52 cases of adenomyosis.All patients underwent transvaginal and transabdominal color Doppler ultrasound diagnosis,the value of differential diagnosis between uterine fibroids and adenomyosis using transvaginal and transabdominal color Doppler ultrasound was analyzed.Results The diagnostic coincidence rate of transabdominal color Doppler ultrasound combined with transvaginal color Doppler ultrasound was higher than that of transabdominal color Doppler ultrasound,and the difference was statistically significant(P<0.05);there was no significant difference in the diagnosis coincidence rate with transvaginal color Doppler ultrasound.The resistance index(RI)and pulsative index(PI)of uterine fibroids were lower than those of adenomyosis,systolic velocity(Vs)was slower than adenomyosis,and end of diastolic velocity(Vd)was faster than adenomyosis,the difference was statistically significant(P<0.05).The circular blood flow signal around the uterine fibroid is concentrated in the subserosal and submucosal pedicle of the fibroid;There is less blood flow signal around adenomyosis and internal star shaped blood flow signal.Conclusion The diagnostic effect of transvaginal combined with transabdominal color Doppler ultrasound for uterine fibroids and adenomyosis is superior to that of individual diagnosis,and there is significant difference in the color Doppler ultrasound blood flow signal performance between the two diseases.