阴道三维彩色多普勒超声对子宫腺肌症的诊断价值

目的分析与探讨阴道三维彩色多普勒超声对子宫腺肌症的临床诊断价值与意义,为子宫腺肌症的诊断提供科学依据与指导方法。方法选取保定市第一医院2010年8月至2012年8月期间收治的子宫腺肌症患者共88例,采取经阴道三维彩色多普勒超声和腹部超声进行检查,所有结果均与患者病理学或手术结果相对比,以比较两种检查方法的准确率。结果腹部超声53例符合,16例误诊,19例漏诊,阴道三维彩色多普勒超声76例符合,8例误诊,4例漏诊。阴道三维彩色多普勒超声的灵敏度(84.61%)、特异度(88.89%)、准确度(86.36%)、阳性预测值(91.67%)、阴性预测值(80.00%)均高于腹部超声(64.44%,55.81%,60.23%,39.58%,60.00%)。子宫腺肌症患者阴道三维彩色多普勒超声的影像学特点主要为子宫增大、肌层内部存在稍强回声并伴有增强回声光斑、病灶内存在短条或短枝状血流信号等。结论对于子宫腺肌症患者,采用阴道三维彩色多普勒超声检查具有较高的准确性,且检查安全无创,患者耐受性强。

Study on the Value of Three-dimensional Transvaglnal Color Doppler Ultrasound in the Diagnosis of Uterine Adenomyosis

Objective To explore the value of three-dimensional transvaginal color Doppler ultrasound （3DTVCDU） in the diagnosis of adenomyosis, and provide scientific basis and guidance for the diagnosis of adenomyosis. Methods A total of 88 cases of adenomyosis admitted in Baoding First Hospital from Aug. 2010 to Aug. 2012 were selected as research objects,3DTVCDU and abdominal ultrasound were both applied to all the eases, and all the results were compared with pathology or surgical results to identify the accuracy of the two methods. Results There were 53 cases of comptiance, 16 cases of misdiagonsis, and 19 cases of missed diagnosis in abdominal ultrasound; while the corresponding numbers of 3DTVCDU was 76 cases, 8 cases and 4 cases. The sensitivity, specificity, accuracy, positive predictive value and negative predective value of the 3DTVDCU were all higher than the abdominal uhrasound（84.61% vs 64.44%, 88.89% vs 55.81% ,86.36% vs 60.23% ,91.67% vs 39.58% ,80.00% vs 60.00% ）. Imaging features of threedimansional transvaginal color Doppler ultrasound of adenomyosis patients mainly included uterus enlargement,strong echo in myometrium accompanied by enhanced echo spot, short article or short branch shaped blood flow signals in lesions, etc. Conclusion For patients with adenomyosis, three-dimensional transvaginal color Doppler ultrasound and is safe and non-invasive, with high accuracy and tolerance of patients.