彩色多普勒超声对剖宫产腹壁子宫内膜异位症的诊断价值

目的探讨彩色多普勒超声对剖宫产术后腹壁子宫内膜异位症（ AWE ）的临床诊断价值。方法回顾性分析2012年1月至2015年6月西昌市人民医院46例经病理证实为剖宫产术后AWE患者的临床资料与彩色多普勒超声表现。结果彩色多普勒超声对AWE诊断准确率为97.83％,彩色多普勒超声表现：无钙化灶,肿块形态及大小不规则,横纵比≤1,内部不均匀低回声,病灶边界不清晰,CDFI可见内部及外周无或少量血流信号,动脉血流呈“高阻低速”型,肿块大小及回声可随月经周期变化而变化。肿块直径＜3 cm的潜伏期较短、位置表浅、病灶多呈卵圆形或椭圆形,病灶多无血流或少血流;直径≥3 cm病灶潜伏期较长、位置较深,病灶多为不规则形态,且血流信号较为丰富;直径＜3 cm潜伏期（2.52±0.98）年、病灶直径（1.61±0.54）cm、病灶形态不规则（68.75％）、病灶深度（22例腹直肌前鞘及皮下脂肪层,10例腹横筋膜／全层腹壁）、CDFI血流（10例无,19例少量,3例丰富）;直径≥3 cm分别为（3.90±1.43）年、（4.35±1.42） cm、89.47％形态不规则、病灶深度（4例腹直肌前鞘及皮下脂肪层,15例腹横筋膜／全层腹壁）、CDFI血流（3例无,8例少量,8例丰富）,组间比较差异有统计学意义（ P＜0.05）。结论彩色多普勒超声结合病史及临床表现可对剖宫产术后AWE做出准确定位及定性诊断,是一种简便可靠的AWE诊断方法。

Research of diagnostic effect of color Doppler ultrasound in abdominal wall endometriosis after caesarean section

Objective To investigate the diagnostic value of color Doppler ultrasound for abdominal wall endometriosis ( AWE) after caesarean section.Methods The clinical data and manifestation of color Doppler ultrasoundof 46 AWE patients confirmed by surgery and pa-thologywere retrospectively analyzed.Results The diagnostic accuracy of color Doppler ultrasound for AWEwas 97.83%.Withcolor Doppler ultrasonography,threre was no calcification,irregularmorphology and size ,with aspect ratio ≤1,uneven and low echoes inside , blurred mar-gins,and the CDFI showed no or a small amount offlow signals ,whose artery displayed "low speed and high resistance",and tumor size and echo might vary with the menstrual cycle changes.Compared with≥3 cm group,the latent period of <3 cm groupnodules were shorter ,the lo-cationwas more superficial ,the shapewas round or oval ,and there was no or few vascularity;the latent period of≥3 cm group was longer ,loca-tion wasdeeper,the shape was irregular ,and the vascularity was abundant.In the tumor diameter<3 cm group,the latent period was (2.52 ± 0.98) years, lesion diameter was (1.61 ±0.54 ) cm,irregularmorphology was 68.75%,with location (22 cases of rectus abdominis sheath and subcutaneous fat layer and 10 cases of abdominal transverse fascia /full-thickness abdominal wall ) and CDFI blood flow ( no in 10 ca-ses, poor in 19 cases, and rich in 3 cases)as listed in brackets;thosein the tumor diameter≥3 cm group were (3.90 ±1.43) years,(4.35 ± 1.42) cm, 89.47%irregularmorphology, location (4 cases of rectus abdominis sheath and subcutaneous fat layer and 15 cases of abdominal transverse fascia /full-thickness abdominal wall), CDFI blood flow(no in 3 cases,poor in 8 cases, and rich in 8 cases), respectively, and the differences between the groups were significantstatistically ( P<0.05 ).Conclusion Color Doppler ultrasound , whenproperly combined with the illness history and clinical manifestations , can make an accurate diagnosis of localization and characterization ,which may be a simple and reliable method in the diagnosis of AWE.