超声弹性成像技术联合宫腔镜对子宫宫腔病变的诊断价值

摘要/Abstract

摘要： 目的探讨与分析超声弹性成像技术联合宫腔镜对子宫宫腔病变的诊断价值。方法选择2020年4月—2022年12月在淄博市妇幼保健院诊治的87例子宫宫腔病变患者作为研究对象,所有患者都给予超声弹性成像技术联合宫腔镜检查,并给予病理检查并判断诊断价值。结果在87例患者中,病理诊断为子宫内膜癌17例(恶性组);子宫内膜息肉32例,子宫内膜炎18例,子宫黏膜下肌瘤16例,子宫内膜不典型增生4例(良性组)。恶性组的超声弹性成像技术评分明显高于良性组,差异有统计学意义（P<0.05）,判断为恶性病变14例,良性病变73例。宫腔镜诊断为子宫内膜癌13例,子宫内膜息肉33例,子宫内膜炎19例,子宫黏膜下肌瘤17例,子宫内膜不典型增生5例,宫腔镜检查总准确率为90.8%(79/87)。超声弹性成像技术联合宫腔镜判断为恶性病变16例,良性病变71例。超声弹性成像技术、宫腔镜、超声弹性成像技术联合宫腔镜鉴别诊断子宫宫腔病变良恶性的敏感性分别为82.3%(14/17)、64.7%(11/17)、94.1%(16/17),特异性分别为100.0%(70/70)、97.1%(68/70)、100.0%(70/70),超声弹性成像技术联合宫腔镜鉴别诊断子宫宫腔病变良恶性的敏感性高于宫腔镜检查,差异有统计学意义（P<0.05）,其他方法的诊断敏感性与特异性比较,差异无统计学意义（P>0.05）。结论超声弹性成像技术联合宫腔镜对子宫宫腔病变组织良恶性的判断具有更高的敏感性与特异性,有较好的应用价值。

关键词: 超声弹性成像技术, 宫腔镜, 子宫宫腔病变, 子宫内膜癌, 敏感性, 特异性

Abstract: Objective To explore and analysis the diagnostic values of ultrasonic elastography combined with hysteroscopy for uterine cavity lesions. Methods From April 2020 to December 2022, 87 cases of patients with uterine cavity lesions who were diagnosed and treated at Zibo Maternal and Child Health Hospital were selected as the research subjects. All patients were underwent ultrasonic elastography combined with hysteroscopy, and pathological examination were performed to determine the diagnostic value. Results The pathological diagnosis were endometrial cancer in 17 cases (malignant group), endometrial polyps in 32 cases, endometritis in 18 cases, submucosal fibroids in 16 cases, and atypical endometrial hyperplasia in 4 cases (benign group) in the 87 cases. The ultrasound elastography score of the malignant group were significantly higher than that of the benign group (P<0.05), with 14 cases diagnosed as malignant and 73 cases as benign. Hysteroscopy diagnosed 13 cases of endometrial cancer, 33 cases of endometrial polyps, 19 cases of endometritis, 17 cases of submucosal fibroids, and 5 cases of atypical endometrial hyperplasia. The overall accuracy of hysteroscopy were 90.8%(79/87). The combination of ultrasonic elastography and hysteroscopy identified 16 cases of malignant lesions and 71 cases of benign lesions. The sensitivity of ultrasonic elastography, hysteroscopy, and the combination of ultrasonic elastography and hysteroscopy in differential diagnosis of benign and malignant uterine cavity lesions were 82.3% (14/17), 64.7% (11/17), and 94.1% (16/17), respectively, with specificity of 100.0% (70/70), 97.1% (68/70), and 100.0% (70/70). The sensitivity of ultrasonic elastography combined with hysteroscopy in differential diagnosis of benign and malignant uterine cavity lesions were higher than that of hysteroscopy (P<0.05). There were no significant difference in the diagnostic sensitivity and specificity of other methods (P>0.05). Conclusion Ultrasound elastography combined with hysteroscopy has higher sensitivity and specificity in the diagnosis of benign and malignant uterine cavity lesions, and has better application value.

Key words: elastic imaging technology, hysteroscopy, uterine cavity lesions, endometrial cancer, sensitivity, specificity

中图分类号:

赵萌. 超声弹性成像技术联合宫腔镜对子宫宫腔病变的诊断价值[J]. 中华养生保健, 2024, 42(7): 173-176.

ZHAO Meng. Diagnostic Value of Ultrasound Elastography Combined with Hysteroscopy for Uterine Cavity Lesions[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(7): 173-176.

参考文献

[1] 吴娟,董晓花,张群青.三维超声技术检查子宫内膜血流参数对宫腔粘连的诊断效果分析[J].检验医学与临床,2023,20(2):220-223,227.
[2] 王琴,王金萍,李燕,等.研究经阴道实时三维子宫输卵管超声造影中造影剂逆流影响因素[J].中国临床医学影像杂志,2023,34(1):51-55,60.
[3] 王晋,罗红,田雨,等.剪切波弹性成像在宫内占位病变中的诊断价值[J].中国超声医学杂志,2023,39(1):66-69.
[4] 谢敏敏,胡兵,卢佳.多参数超声诊断子宫腺肌病研究进展[J].中国介入影像与治疗学,2023,20(2):121-123.
[5] SIGRIST R M S, LIAU J, KAFFAS A E, et al. Ultrasound Elastography: Review of Techniques and Clinical Applications[J]. Theranostics,2017,7(5):1303-1329.
[6] LASMAR R B, LASMAR B P.Hysteroscopic management of intrauterine benign diseases[J]. Minim Invasive Ther Allied Technol,2021,30(5):263-271.
[7] 李基璨,赵玉丹.超声弹性成像鉴别卵巢囊肿和子宫内膜异位症的价值[J].中国妇幼保健,2022,37(4):765-768.
[8] 孙茜,王峥,王利娜,等.经阴道超声与剪切波弹性成像技术对子宫内膜癌的诊断价值[J].癌症进展,2022,20(17):1810-1812.
[9] 娜菲莎·艾力,古力斯坦·卡迪尔,张利.超声弹性成像参数在卵巢囊肿与子宫内膜异位症鉴别诊断中的应用价值[J].中国医学装备,2022,19(3):89-92.
[10] 高敏,史铁梅,张原溪,等.超声弹性成像在子宫内膜病变中的研究进展[J].中国医学影像技术,2018,34(5):783-786.
[11] 耿华锋,张树颖,赫东芸.子宫内膜癌术前影像学应用进展[J].现代妇产科进展,2021,30(11):866-868.
[12] 方文静,郭美红,林秀梅,等.SWE在评估复发性流产患者子宫内膜容受性的应用价值[J].医学影像学杂志,2021,31(11):1936-1938,1942.
[13] 张喜梅,张梦圆.SWE联合经阴道超声对子宫内膜癌的诊断分析[J].现代诊断与治疗,2021,32(8):1181-1183.
[14] 汪期明,张海霞,朱淼华,等.实时剪切波超声弹性成像在备孕期女性子宫内膜容受性中的应用研究[J].中国超声医学杂志,2021,37(10):1151-1154.
[15] 余彩茶,水旭娟,焦岩,等.实时剪切波弹性成像在评估子宫内膜容受性中的初步应用[J].中国全科医学,2020,23(21):2678-2681.
[16] 范丽萍,庞慧贤,卫红艳,等.实时超声弹性成像在子宫内膜癌浸润子宫肌层中的诊断价值[J].中国医学工程,2019,27(8):85-86.
[17] 杨基兰,何利群,刘琪,等.经阴道彩色多普勒超声联合弹性成像在子宫恶性肿瘤早期诊断中的临床应用分析[J].实用癌症杂志,2019,34(7):1116-1119.
[18] 马慧,杨宗利,张丰明,等.经阴道常规超声联合剪切波弹性成像对子宫内膜癌的鉴别诊断价值[J].中华超声影像学杂志,2019,28(4):330-335.
[19] 赵治. 超声弹性成像对子宫内膜异位和出血性卵巢囊肿的鉴别诊断价值[J].山东医药,2019,59(22):74-76.
[20] 高敏,史铁梅,木其尔,等.实时剪切波弹性成像技术定量评价子宫内膜增生[J].中国医学影像技术,2019,35(5):793-795.