子宫内膜癌超声造影增强时相和肿瘤显像的初步研究

目的 观察子宫内膜癌的实时超声造影增强时相特点,评价在常规超声基础上进行的超声造影检查对子宫内膜癌宫腔病变显像的价值.方法 术前对35例经诊断性刮宫病理诊断为子宫内膜癌的患者行经阴道超声检查和超声造影检查.以病变周边肌层(除滋养血管走行区)作为参照,观察子宫内膜癌病变超声造影增强和廓清的顺序,并将病变血流灌注显示状况分为3级(0级、Ⅰ级和Ⅱ级),对常规超声CDFI技术和超声造影对病变血流的显示结果进行比较和分析.结果 超声造影清晰显示34例子宫内膜癌病灶,其中28例(82.4%,28/34)早增强,6例(17.6%,6/34)晚增强;16例(47.1%,16/34)早廓清,18例(52.9%,18/34)晚廓清.CDFI血流分级为0级4例、Ⅰ级19例、Ⅱ级11例;超声造影血流分级为Ⅰ级3例、Ⅱ级31例、无0级病例,超声造影对子宫内膜癌血流的显示率高于常规超声.超声造影为8例(23.5%,8/34)病变的显像提供了较常规超声更加丰富的诊断信息.结论 子宫内膜癌超声造影增强时相有一定的特征性;超声造影较常规超声可显示出更多的子宫内膜癌病变的血流信息.因此超声造影在子宫内膜癌诊断中是常规超声有效的辅助检查方法.

Preliminary research of contrast-enhanced ultrasound in endometrial carcinoma enhancement phase and tumor imaging

Objective To observe the enhancement phase of endometrial carcinoma in contrast-enhanced ultrasound（CEUS） and evaluate the utility of CEUS as an adjunct to conventional transvaginal ultrasound（TVUS） for endometrial carcinoma imaging.Methods A total of 35 patients with endometrial carcinoma diagnosed by endometrial sampling were examined before operations using TVUS followed by CEUS.The contrast enhancement phases and patterns were visually observed with the surrounding myometrium as background in this group of endometrial carcinoma.The blood supply of the tumor was divided into 3 grades separately in CDFI and CEUS models.The results of the two different models were compared statistically.The effectiveness of CEUS as an adjunct to TVUS in tumor imaging was evaluated.Results As for enhancement phase,there were 28（82.4%,28/34） cases showing early wash-in and 6（17.6%,6/34） late wash-in.The cases of early wash-out and late wash-out were 16（47.1%,16/34） and 18（52.9%,18/34）,respectively.As for tumor blood supply,the cases of grade 0,1 and 2 were 5,19 and 11 in CDFI model,while 0,3 and 31 in CEUS model respectively.The detection rate of blood supply in CEUS model was higher than that in CDFI model.In tumor imaging,CEUS was helpful in enhancing tumor-to-tissue contrast in 8 cases（22.9%,8/34）,in which the endometrium were thin after endometrial biopsy.Conclusions This study reveals the enhancement phase of endometrial carcinoma.CEUS can provide more information on tumor blood supply than CDFI model.These characteristics of CEUS make it a valuable adjunct to conventional ultrasound in imaging of endometrial carcinoma.