宫腔声学造影联合三维能量多普勒定量分析对宫腔内病变的诊断价值

目的：探讨生理盐水宫腔声学造影（SIS）结合三维能量多普勒（3D-PDI）定量分析对宫腔内病变的鉴别诊断价值。方法：选择常规阴道超声（TVS）提示宫腔内病变的109例已婚妇女进行SIS及3D-PDI成像，运用VOCAL软件对获得的三维能量图进行定量分析，并与病理结果进行对照。结果：109例患者中，内膜息肉40例，黏膜下肌瘤48例，内膜增生16例，血凝块9例。TVS联合彩色多普勒血流显像（CDFI）诊断内膜息肉的准确率、特异度及敏感度分别为：78%、80%、75%；SIS联合3D-PDI诊断内膜息肉的准确率、特异度及敏感度分别为：98%、97%、98%。子宫内膜息肉组和子宫黏膜下肌瘤组的血管化指数、血流指数、血管化血流指数比较差异均有统计学意义（P＜0.05）。结论：SIS能清晰显示宫腔内的病灶，而3D-PDI可显示病灶的血流灌注类型并进行定量分析，两者结合明显提高了宫腔内病变的诊断敏感性及特异性。

The value of sonohysterography combined with quantitative analysis of three-dimensional power Doppler imaging in the diagnosis of intrauterine lesions

Objective: To investigate the value of saline infusion sonohysterography (SIS) combined with quantitative analysis of three-dimensional power Doppler imaging (3D-PDI) in the differential diagnosis of intrauterine lesions. Methods: SIS and 3D-PDI were carried on 109 cases of married women with transvaginal ultrasonography (TVS) prompting intrauterine lesions. A quantitative analysis was made by VOCAL software and the pathological results were compared. Results: Of all the 109 patients, there were 40 cases of endometrial polyp, 48 cases of submucosal fibroid, 16 cases of intimal hyperplasia and 9 cases of blood clot. The accuracy rate, specificity and sensitivity of TVS combined with color Doppler flow imaging (CDFI) in diagnosis of endometrial polyp were 78%, 80%, 75% respectively, while those of SIS combined with 3D-PDI were 98%, 97%, 98% respectively. The differences in VI, FI and VFI between endometrial polyp group and submucosal fibroid group were significant (P<0.05). Conclusion: SIS can show clearly the intrauterine lesions while 3D-PDI can display the lesion types of perfusion and quantitative analysis is able to be performed. The combination of both procedures may significantly improve the sensitivity and specificity of intrauterine lesion diagnosis.