子宫内膜癌T分期经阴道超声与病理诊断对照研究

目的通过与病理对照研究,探讨经阴道超声子宫内膜癌的表现与分期的相关性。方法41例子宫内膜癌经阴道超声检查,先观察子宫内膜及肌层的二维图像,记录二维图像特征,然后观察彩色血流情况,测得动脉血流阻力指数并记录。最后将超声结果与手术病理分期结果对照,进行统计学处理。结果经阴道腔内超声测得内膜厚度范围5.6~52mm,Ⅰa期患者平均子宫内膜厚度为7.2mm,Ⅰb期为23.2mm,Ⅰc期为29.7mm,各期之间有显著差异(P<0.01);Ⅰa期为66.6%(2/3例),Ⅰb期为85.7%(18/21例),Ⅰc期血流显示率为88.2%(15/17例),肿瘤内血流分级越高,肿瘤浸润深度越深;Ⅰa期患者阻力指数平均为0.52,Ⅰb期为0.42,Ⅰc期为0.50,肿瘤内血管的阻力指数在各期肿瘤中无显著差异。结论经阴道超声检查可提供子宫内膜厚度和血流情况的准确信息,二者与子宫内膜癌的浸润深度相关,可作为子宫内膜癌手术前分期的检查方法。

Contrast Study on T-Staging of Endometrial Cancer with Transvaginal Ultrasound to Its Pathological Diagnosis

Objective To evaluate the correlation of transvaginal ultrasonic features of endometrial cancer with its staging through the contrast study to pathology.Method Transvaginal ultrasound were performed preoperatively on 41 cases of endometrial cancer.2D imagings of endometria and myometrioum was observed and their characteristics was recorded.Then the color blood flow was observed to determine and record the resistance index(RI) of arterial blood.Finally,the ultrasonic results were contrasted to pathological staging proven by operation.Results The endometrial thickness determined by transvaginal ultrasound was 5.6~52mm,while its mean value was 7.2,23.2 and 29.7mm for pathological stage Ⅰa,Ⅰb and Ⅰc respectively.There were significant differences among each stage.The displaying rate of intratumoral blood flow was 66.6%(2/3),85.7%(18/21),88.2%(15/17) for stage Ⅰa,Ⅰb and Ⅰc respectively.The higher the grading of blood flow was,the severer the infiltration of tumor was.The mean value of RI was 0.52,0.42 and 0.50 for stage Ⅰa,Ⅰb and Ⅰc respectively.There was no significant diference among each stage.Conclusions The thickness of endometria and the blood flow could be determined by transvaginal ultrasound.They were correlated with the infiltration of tumor.Transvaginal ultrasound could be used as a preoperative staging method for endometrial cancer.