超声造影强化在子宫肌瘤和子宫腺肌症鉴别诊断中的应用价值

目的]探讨超声造影强化在子宫肌瘤和子宫腺肌症鉴别诊断中的应用价值.方法]采用新型超声造影剂结合超声造影技术进行超声造影强化,观察子宫局部病灶患者105例的血流灌注特点,对单发子宫肌瘤、多发子宫肌瘤、单发子宫腺肌症、多发子宫腺肌症及肌瘤合并腺肌症进行鉴别诊断,并与常规超声诊断及穿刺病理检查结果进行对照验证,比较超声造影强化和常规超声的灵敏度、特异性、阳性预测值、阴性预测值.结果]超声造影强化组在单发肌瘤、多发肌瘤、单发腺肌症、多发腺肌症、肌瘤合并腺肌症等检出率明显高于常规超声组,超声造影组的确诊率为93.3％(98/105),明显高于常规超声组59.0％(62/105),其差异有统计学意义(x2=4.941,P=0.022).超声造影组灵敏度、特异性、阳性预测值、阴性预测值分别为97.5％、97.1％、98.7％、94.4％,均显著高于常规超声组65％、60％、78.8％、42.9％.在超声造影强化中,子宫肌瘤的始增时间、达峰时间和峰值强度均显著高于子宫腺肌症(P＜0.05).结论]与常规超声比较,超声造影强化有较高的确诊率,在子宫肌瘤和子宫腺肌症鉴别诊断中有较高的应用价值,值得临床推广应用.

Study on Contrast-Enhanced Ultrasound Value in the Differential Diagnosis of Uterine Fibroids and Adenomyosis

Objective]To explore the value of contrast-enhanced ultrasound value in the differential diagnosis of uterine fibroids and adenomyosis.Methods]Contrast-enhanced ultrasound was used to observe the perfusion characteristics of 105 cases of uterine local lesions.Single uterine fibroids,multiple uterine fibroids,single adenomyosis,multiple adenomyosis and the adenomyosis of myoma underwent differential diagnosis.The sensitivity,specificity,and positive and negative predictive value by contrast-enhanced ultrasound were compared with those by conventional ultrasound and postoperative pathological diagnosis.Results] Compared to the conventional ultrasound group,the contrast-enhanced ultrasound group had significantly higher detection rates of single myoma,multiple myoma,single adenomyosis,multiple adenomyosis and adenomyosis of myoma.The difference between contrast-enhanced ultrasound group and conventional ultrasound group was 93.3％ (98/105) versus 59％ (62/105),respectively,which showed statistically significant (x2 =4.941,P =0.022).The sensitivity,specificity,positive predictive value and negative predictive value of contrast-enhanced ultrasound were 97.5 ％,97.1％,98.7 ％ and 94.4 ％,respectively,significantly higher than those of the conventional ultrasound group 65％,60％,78.8％ and 42.9％,respectively.In the contrast-enhanced ultrasound group,the time of onset,peak time and peak intensity of uterine leiomyoma were significantly higher than those of adenomyosis (P ＜0.05).Conclusion]Compared to conventional ultrasound,contrast enhanced ultrasound has a high diagnostic rate in the differential diagnosis of uterine fibroids and adenomyosis and is worthy of clinical application.