经阴道三维彩色能量图鉴别子宫肌瘤和子宫腺肌瘤

目的探讨经阴道三雏超声成像和三维能量多普勒对诊断子宫肌瘤和子宫腺肌瘤的临床价值。方法应用经阴道三维超声成像和三维能量多普勒成像对45倒二维超声疑为子宫肌瘤或子宫腺肌瘤者进行检测，并对其血流频谱进行对照，分析两者对子宫肌瘤和腺肌瘤鉴定的可能性。结果38例子宫肌瘤患者清晰显示瘤体的血流灌注呈球体网架结构，与正常子宫肌层之间存在分界，而且瘤周血供较瘤中央丰富；7例子宫腺肌瘤患者显示瘤体与子宫肌层分界不清，血供分布杂乱。结论少数病例子宫腺肌瘤和子宫肌瘤声像图表现相似，确定团块边界是否清晰厦包块有无包绕的血流信号对鉴别病灶腺肌瘤和子宫肌瘤有重要价值，尤其是三雏能量多普勒检查，能显示子宫肌瘤表现的“立体网架样”或“抱球样”的特征性表现，有助于瘤体的定位、定性和定量诊断.

Three-dimensional Power Doppler for Differential Diagnosis of Hysteromyoma and Adenomyoma

Objective To investigate the value of transvaginal three-dimensional uhrasonography combines with three-dimensional power Doppler imaging for the diagnosis of hysteromyoma and adenomyoma. Methods Total 45 patients suspected hysteromyoma or adenomyoma were examined with transvaginal three-dimensional ultrasonography combines with three-dimensional power Doppler imaging. All cases were confirmed by operation and pathology. Results 38 eases were the hysteromyoma and 7 cases were the adenomyoma. Blood flow perfusion in hysteromyoma in 38 cases displayed spherical reticular feature. There was a line bordered between hysteromyoma and myometrium and blood supply around myoma was richer than its center. For the 7 case of adenomyoma,there was not any lines bordered between adenomyoma and myometrium, and blood supply around myoma was disorder. Conclusions A few cases of hysteromyoma and adenomyoma behave familiar. Whether the boundary of conglomeration is clear or not and the existence of blood sign around agglomeration are very important value for the diagnosis of the hysteromyoma and adenomyoma. The imaging stereo structure by the three-dimensional power Doppler is specially contributed to display of the royonm position and blood supply. And it is conducive to quantitative analysis by pulse Doppler sampling to acqui,,e frequency speetrum.