三维容积和能量多普勒血流参数对绝经期子宫内膜良恶性病变的鉴别诊断价值

目的 探讨三维容积及能量多普勒血流参数对绝经后出血患者子宫内膜良恶性病变的诊断价值.方法 对84例子宫内膜病变患者行三维能量多普勒超声检查,以病理结果分为良性组(子宫内膜息肉30例,子宫内膜增生34例)和恶性组(子宫内膜癌20例),应用接受者操作特性曲线(ROC曲线)比较各项指标的诊断价值.结果 两组间内膜体积比较差异无统计学意义(P>0.05),三维能量多普勒血流参数比较差异有统计学意义(P<0.01).血管指数(V1)、血流指数(FI)和血管-血流指数(VFI)的曲线下面积(AUC)分别为0.976、0.888和0.894.其中VI的曲线下面积最大,当VI的截断值为2.97%时,敏感性为95%,特异性为86%.结论 三维能量多普勒血流参数对绝经期出血患者内膜良恶性病变具有较高的诊断价值.

Abstract：

Objective To evaluate the value of three-dimensional power Doppler imaging(3D-PDI) in the discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Methods Eighty-four women with post menopausal bleeding who examined by 3D-PDI were enrolled. All patients scheduled for pathological examination were divided into benign group (30 cases with endometrial polyps and 34 cases with hyperplasia) and malignant group (20 cases with endometrial carcinoma). Endometrial volume, vascularity index ( VI) , flow index ( FI) and vascularity flow index ( VFI) were measured. The diagnostic value of parameters derived from 3D-PDI was evaluated by using the receiver operating characteristic ( ROC) curve. Results Differences of these parameters (VI, FI and VFI) were considered statistically significant between two groups, the parameters of endometrial volume had no significant differences between two groups; the area under ROC curve(AUC) of the meaningful data were 0.976,0.888 and 0.894 respectively. Among these parameters, VI had the highest diagnostic value for discriminating between benign and malignant endometrium, the cut-off value of which was 2. 97 with a sensitivity of 95% and a specificity of 86%. Conclusions 3D-PDI is a good diagnostic tools in the discriminations between benign and malignant endometrium in women with postmenopausal bleeding.

Value of three-dimensional power Doppler imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding

Objective To evaluate the value of three-dimensional power Doppler imaging(3D-PDI) in the discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Methods Eighty-four women with post menopausal bleeding who examined by 3D-PDI were enrolled. All patients scheduled for pathological examination were divided into benign group (30 cases with endometrial polyps and 34 cases with hyperplasia) and malignant group (20 cases with endometrial carcinoma). Endometrial volume, vascularity index ( VI) , flow index ( FI) and vascularity flow index ( VFI) were measured. The diagnostic value of parameters derived from 3D-PDI was evaluated by using the receiver operating characteristic ( ROC) curve. Results Differences of these parameters (VI, FI and VFI) were considered statistically significant between two groups, the parameters of endometrial volume had no significant differences between two groups; the area under ROC curve(AUC) of the meaningful data were 0.976,0.888 and 0.894 respectively. Among these parameters, VI had the highest diagnostic value for discriminating between benign and malignant endometrium, the cut-off value of which was 2. 97 with a sensitivity of 95% and a specificity of 86%. Conclusions 3D-PDI is a good diagnostic tools in the discriminations between benign and malignant endometrium in women with postmenopausal bleeding.