子宫肌瘤和子宫腺肌病经腹部彩色多普勒超声临床鉴别价值探讨

Value of Abdominal Color Doppler Ultrasonography in the Differential Diagnosis of Uterine Fibroids and Adenomyopathy

目的:分析经腹部彩色多普勒超声对子宫肌瘤和子宫腺肌病的诊断鉴别情况。方法:选取2019年5月—2023年5月新疆第六师医院102团分院收治的子宫肌瘤和子宫腺肌病患者180例作为研究对象,均实施经腹部彩色多普勒超声诊断,将随访病理结果作为“金标准”。比较两种疾病的检查情况。结果:经腹部彩色多普勒超声诊断子宫肌瘤的准确度90%、特异度50%、灵敏度98.78%,经腹部彩色多普勒超声诊断子宫腺肌病的准确度88.89%、特异度62.5%、灵敏度97.56%。子宫肌瘤的子宫动脉搏动指数及阻力指数低于子宫腺肌病,差异有统计学意义(P<0.05)。子宫肌瘤声像图特征呈低回声,少数会出现等回声或者稍高的回声,当病灶体积较大时,内部出现螺旋回声情况,还会伴随衰减声影,肌瘤边界较为清晰。肌瘤周围能够看到环状或者半环状血流束,肌瘤内部会出现点状血流。子宫腺肌病无明显的血流信号,组织内部表现为微量点状血流,子宫出现增大情况,形态表现为球状,边界较为模糊。病灶大多位于子宫后壁,回声大多呈网格或者粗颗粒形状,子宫后侧位置还会出现声影。结论:对于子宫肌瘤、子宫腺肌病患者实施经腹部彩色多普勒超声诊断具有较高的准确性,能够很好地鉴别疾病类型,从而为临床治疗提供指导。

Objective:To analyze the diagnosis and differentiation of uterine fibroids and adenomyopathy by abdominal color Doppler ultrasonography.Methods:A total of one hundred and eighty patients with uterine fibroids and adenomyosis admitted to Xinjiang Sixth Division Hospital 102nd Regiment Branch from May 2019 to May 2023 were selected as the study objects,and all of them were diagnosed by transabdominal color Doppler ultrasonography.Following up pathology results as the"gold standard",the test results of the two diseases were compared.Results:The accuracy,specificity and sensitivity of abdominal color Doppler ultrasonography in the diagnosis of uterine fibroids were 90%,50%and 98.78%;the accuracy,specificity and sensitivity of abdominal color Doppler ultrasonography in the diagnosis of adenomyopathy were 88.89%,62.5%and 97.56%;the pulsation index and resistance index of uterine artery in uterine fibroids were lower than those in adenomyosis,and the difference was statistically significant(P<0.05);the ultrasonographic characteristics of uterine fibroids are low echo,and a few appeared equal echo or slightly higher echo,when the size of the lesion was large,spiral echo appeared inside,accompanied by attenuation sound shadow,and the boundary of the fibroids was relatively clear;annular or semi-annular blood streams could be seen around the fibroids,and punctured blood flow could appear inside the fibroids;there was no obvious blood flow signal in adenomyosis,the internal tissue showed a trace of punctated blood flow,the uterus appeared enlarged,the shape was spherical,and the boundary was blurred;most of the lesions were located in the posterior wall of the uterus,and the echoes were mostly in the shape of grid or coarse particles,and the sound shadows also appeared in the posterior position of the uterus.Conclusion:For patients with uterine fibroids and adenomyopathy,transabdominal color Doppler ultrasonography diagnosis has high accuracy,and can identify disease types well,so as to provide guidance for clinical treatment.