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应用

Abdominal color Doppler ultrasound in the differential diagnosis of uterine myoma and adenomyosis

目的:探讨腹部彩色多普勒超声(以下简称腹部彩超)鉴别诊断子宫肌瘤(UM)与子宫腺肌病(AM)的价值。方法:队列研究。抽取2021年6月至2023年6月商丘市第一人民医院收治的且经术后病理结果证实的64例UM患者和60例AM患者进行研究。纳入对象均有完整资料,术前均接受腹部彩超检查。以手术病理结果作为标准,统计腹部彩超诊断结果,并比较UM与AM患者彩超子宫动脉血流参数[阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)、舒张期峰值流速(EDV)]。结果:腹部彩超检出符合UM患者59例,AM患者56例,检出符合率分别为92.18%、93.33%,两种疾病腹部彩超诊断检出符合率比较差异未见统计学意义差异(P>0.05)。UM、AM患者PS、ED比较差异未见统计学意义(P>0.05),但RI与PI比较差异有统计学意义(P<0.05)。结论:在UM、AM诊断中应用腹部彩超有较好的价值,其检出符合率高,而且可根据彩超子宫动脉血流参数中的RI与PI进行UM、AM鉴别,从而为临床提供可靠的依据。

Objective:To investigate the value of abdominal color Doppler ultrasound in the differential diagnosis of uterine myoma(UM)and adenomyosis(AM).Methods:Sixty-four UM patients and 60 AM patients who were confirmed by postoperative pathological results in the First People’s Hospital of Shangqiu from June 2021 to June 2023 were selected for the cohort study.The included subjects had complete data and received preoperative abdominal color Doppler ultrasound examination.The surgical pathological results were taken as the standard,and the results of abdominal color Doppler ultrasound diagnosis were counted.The ultrasound uterine artery blood flow parameters,including resistance index(RI),pulsatility index(PI),peak systolic velocity(PSV)and end-diastolic velocity(EDV),were compared between the UM and AM patients.Results:Abdominal color Doppler ultrasound detected out 59 patients with UM and 56 patients with AM,and the detection coincidence rate was 92.18%and 93.33%,respectively.There was no significant difference in the detection coincidence rate of abdominal color Doppler ultrasound in the diagnosis of the two diseases(P>0.05).There was no significant difference in PS and ED between UM and AM patients(P>0.05),but there were significant differences in RI and PI(P<0.05).Conclusions:Abdominal color Doppler ultrasound has great value in the differential diagnosis of UM and AM,of which the detection coincidence rate is high.Moreover,the uterine artery blood flow parameters,RI and PI,can be used to identify UM and AM,so as to provide a reliable basis for clinical application.