摘要
目的分析二维超声联合三维能量多普勒对绝经后女性子宫内膜病变的鉴别价值。方法选择2019年5月-2022年5月温州市中西医结合医院妇科就诊的214例绝经后子宫内膜病变患者作为研究对象。按照病理检查结果分为良性病变组(109例)、不典型增生组(68例)、子宫内膜癌组(37例)。所有研究对象均行阴道超声检查,获取子宫内膜厚度、二维血流分级、三维能力多普勒血流参数。结果良性病变组、不典型增生组、子宫内膜癌组子宫内膜逐渐增厚(F=15.392,P<0.001),血管指数(VI)、血流指数(FI)、血管血流指数(VFI)逐渐升高(均P<0.001),血流2、3级构成比逐渐升高(Z=5.994,P<0.001)。患者BMI、子宫内膜厚度、血流3级、VFI是子宫内膜病变升级的危险因素(OR=2.555、1.941、1.858、2.450,均P<0.05)。子宫内膜厚度、血流3级对子宫内膜良性病变与不典型增生具有鉴别价值(AUC=0.770、0.811,P<0.05)。VFI对子宫内膜良性病变与不典型增生、不典型增生与子宫内膜癌具有鉴别价值(AUC=0.793、0.859,P<0.001)。在子宫内膜厚度>7.6 cm、血流3级及VFI>11中,满足1项、2项、3项与病理诊断符合率为61.5%、70.7%、90.8%。结论子宫内膜厚度、血流分级联合VFI对绝经后女性子宫内膜病变类型具有较好的鉴别价值。
Objective To analyze the value of transvaginal two-dimensional ultrasound combined with three-dimensional energy Doppler in the differentiation of endometrial lesions in postmenopausal women.Methods A total of 214 postmenopausal patients with endometrial disease in the Department of Gynecology of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were selected as the research objects.The patients were divided into benign lesion group(109 cases),atypical hyperplasia group(68 cases)and endometrial cancer group(37 cases)according to the pathological examination results.All subjects underwent transvaginal ultrasound to obtain endometrial thickness,two-dimensional blood flow classification,three-dimensional power Doppler blood flow.Results The endometrial thickness of the benign lesion group,the atypical hyperplasia group and the endometrial cancer group was gradually thickened(F=15.392,P<0.001),the vascular index(VI),flow index(FI)and vascular flow index(VFI)were gradually increased(all P<0.001),and the flow grade 2 and 3 was gradually increased(Z=5.994,P<0.001).BMI,endometrial thickness,blood flow grade 3,and VFI were risk factors for the progression of endometrial lesions(OR=2.555,1.941,1.858,2.450,all P<0.05).Endometrial thickness and blood flow grade 3 had differential value between benign endometrial lesions and atypical hyperplasia(AUC=0.770,0.811,P<0.05).Endometrial VFI had differential value between benign endometrial lesions and atypical hyperplasia,atypical hyperplasia and endometrial cancer(AUC=0.793,0.859,P<0.001).In the cases of endometrial thickness>7.6 cm,blood flow grade 3 and VFI>11,the coincidence rates of 1,2 and 3 with pathological diagnosis were 61.5%,70.7%and 90.8%,respectively.Conclusion Endometrial thickness,blood flow grading combined with VFI has a good value in differentiating the types of endometrial lesions in postmenopausal women.
作者
陈仙秋
金纬纬
CHEN Xianqiu;JIN Weiwei(Department of Ultrasound,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou,Zhejiang 325000,China;不详)
出处
《中华全科医学》
2023年第8期1370-1373,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2020KY923)。
关键词
超声
血流
三维能量多普勒
子宫内膜
Ultrasound
Blood flow
Three-dimensional energy Doppler
Endometrium
