摘要
目的:探讨彩色多普勒超声成像鉴别诊断子宫肌瘤(UF)和子宫腺肌瘤(AMA)效能。方法:回顾性收集2021年8月-2024年8月在南通瑞慈医院和南通市妇幼保健院收治的子宫病变患者770例临床资料,以组织病理结果为确诊依据,将经阴道与经腹部彩色多普勒超声成像诊断UF与AMA结果与组织病理结果进行对照,比较UF与AMA子宫动脉血流参数,计算诊断效能指标。结果:子宫病变患者770例中,经阴道与经腹部彩色多普勒超声成像检出UF497例、AMA273例,经阴道与腹部彩色多普勒超声检出UF与组织病理诊断UF的Kappa值为0.881,检出AMA与组织病理诊断AMA的Kappa值为0.869(P<0.05)。彩色多普勒超声UF与AMA在宫腔形态、病灶边界、切面回声类型、宫腔线移位、内部囊性液性暗区、假包膜、子宫肌壁生长方向和微钙化等特征均有差异,超声最大血液流速、搏动指数和阻力指数均有差异(均P<0.05)。770例子宫病变患者中,经阴道与经腹部彩色多普勒超声成像检出UF的灵敏度95.6%、特异度93.0%、准确度94.7%、阳性预测值96.2%和阴性预测值91.9%,检出AMA的灵敏度92.2%、特异度95.2%、准确度94.2%、阳性预测值91.2%和阴性预测值95.8%,与检出UF相比,检出AMA的阳性预测值较低、阴性预测值较高(P<0.05)。结论:UF与AMA彩色多普勒超声特征各有不同,经阴道与腹部彩色多普勒超声成像鉴别诊断UF与AMA效能较高。
Objective:To investigate the diagnostic efficacy of the color Doppler ultrasound in the differential diagnosis of the uterine fibroids(UF)and the uterine adenomyoma(UAMA).Methods:The clinical data of 770 patients with uterine lesions who treated in the hospital from August 2021 to August 2024 were collected retrospectively.Based on the histopathological results as the definite diagnosis,the results of UF and UAMA diagnosed by the transvaginal and transabdominal color Doppler ultrasound imaging were compared with the histopathological results as the definite diagnosis.The blood flow parameters were compared between the patients with UF and the patients with UAMA,and the diagnostic efficacy indexes were calculated.Results:In 770 patients with uterine lesions,the transvaginal and transabdominal color Doppler ultrasonography detected 497 cases with UF and 273 cases with AMA.Compared to the detection by histopathology,the Kappa value of the detection of UF or AMA by the transvaginal and transabdominal color Doppler ultrasonography was 0.881 or 0.869(P<0.05).There were significant differences in the characteristics by color Doppler ultrasonography,such as the uterine cavity shape,the lesion boundary,the section echo type,the uterine cavity line shift,the dark area of the internal cystic fluid,the pseudocapsule,the growth direction of the uterine muscle wall and the microcalcification,and the values of the maximum blood flow rate,the pulsatility index and the resistance index of the patients between UF and AMA(all P<0.05).Among 770 patients with uterine lesions,the sensitivity,the specificity,the accuracy,the positive predictive value and the negative predictive value of the transvaginal and transabdominal color Doppler ultrasound for detecting UF of the patients were 95.6%,93.0%,94.7%,96.2%and 91.9%,respectively,and which for detecting AMA of the patients were 92.2%,95.2%,94.2%,91.2%and 95.8%,respectively.Compared with those of UF,the positive predictive value of the transvaginal and transabdominal color Doppler ultrasound for detecting AMA was significantly lower,and the negative predictive value of which was significantly higher(P<0.05).Conclusion:The characteristics UF and AMA examined by color Doppler ultrasound have different,and the transvaginal and abdominal color Doppler ultrasonography for differential diagnosing UF and AMA of the patients has higher efficacy.
作者
陈陆霞
刘丹
陈香
CHEN Luxia;LIU Dan;CHEN Xiang(Nantong Rici Hospital Affiliatedto Yangzhou University,Nantong,Jiangsu Province,226001;The Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong,Jiangsu Province)
出处
《中国计划生育学杂志》
2025年第6期1381-1385,1390,I0001,共7页
Chinese Journal of Family Planning
关键词
子宫肌瘤
子宫腺肌瘤
经阴道彩色多普勒超声
经腹部彩色多普勒超声
鉴别诊断
Uterine Fibroid
Adenomyoma
Transvaginal color Doppler ultrasonography
Abdominal color Doppler ultrasonography
Differential diagnosis
