经阴道超声对子宫内膜癌诊断的评估

Evaluation of transvaginal ultrasonography in diagnosis of uterine endometrial cancers

目的:探讨经阴道超声检查子宫内膜癌的声像图特征及临床特点。方法:对67例子宫内膜癌患者术前经阴道超声检查的声像图特征和临床特点进行了回顾性分析。结果:术前经阴道超声诊断与术后病理结果的符合率是83.6%。超声图像特点:①子宫内膜癌早期子宫内膜层呈不规则增厚,局部回声不均匀增强或呈息肉样突起的改变,外形轮廓规则;②子宫内膜癌中晚期多是子宫增大或子宫大小与停经月份不符,宫腔内有实质不均质性的团块,形态不规则多合并宫腔积液。结论:经阴道超声检查技术可以对子宫内膜癌的及时诊断提供帮助,结合其它临床资料,也可以可靠地鉴别子宫内膜癌和其他宫腔占位性病变。

Objective To investigate the echo traits and the clinical features of uterine endometrial cancers. Methods 46 patients aged 42～78 years with uterine endometrial cancers received the transvaginal ultrasonography (TVS) before operation and their diagnoses were confirmed after operation in pathology. We have made a retrospective analysis of the TVS traits among these patients. Results The match ratio of the TVS and the pathological diagnoses reached 82.6%. The traits of the echo image were①in earlier stage, an irregular thickness of the endometrial layer with a locally asymmetrical, strong echo and a regular contour, or②in middle and late stages, an enlarged uterine size or an inconsistence between its regular size and its post-menopausal phase, with asymmetrical density inter-masses with fluids in the cavity. Conclusion The TVS traits offer an immediate assistance to the diagnosis of the endometrial cancer. Together with other clinical data, it could reliably differentiate the endometrial cancers from other tumors in the uterine cavity.