| 牟瑞雪,古丽娜尔·沙海,向红.三维超声造影鉴别诊断良恶性子宫内膜病变[J].中国医学影像技术,2014,30(12):1901~1904 |
| 三维超声造影鉴别诊断良恶性子宫内膜病变 |
| Three-dimensional contrast-enhanced ultrasonography in differential diagnosis of benign and malignant endometrial lesions |
| 投稿时间：2014-08-08 修订日期：2014-09-16 |
| DOI： |
| 中文关键词: 超声检查 子宫内膜肿瘤 诊断,鉴别 |
| 英文关键词:Ultrasonography Endometrial neoplasms Diagnosis, differential |
| 基金项目:新疆自治区自然科学基金项目(2013211A085)。 |
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| 中文摘要: |
| 目的 探讨三维超声造影(3D-CEUS)鉴别诊断良恶性子宫内膜病变的价值。方法 分析68例经病理确诊的子宫内膜病变患者2D-CEUS及3D-CEUS资料,以病理结果为金标准,计算并比较2D-CEUS及3D-CEUS诊断子宫内膜癌敏感度、特异度、阳性预测值、阴性预测值、准确率及二者判断子宫内膜癌病理分期与病理结果的符合率。结果 68例患者中,良性子宫内膜病变42例,包括子宫内膜息肉19例、子宫内膜增生症10例、囊性萎缩性宫内膜6例、宫腔积血块4例、子宫黏膜下肌瘤3例,子宫内膜癌26例,其中ⅠA期18例、ⅠB期8例。2D-CEUS和3D-CEUS诊断子宫内膜癌敏感度、特异度、阳性预测值、阴性预测值、准确率分别为76.92%(20/26)、73.81%(31/42)、64.52%(20/31)、83.78%(31/37)、75.00%(51/68)和100%(26/26)、97.62%(41/42)、96.30%(26/27)、100%(41/41)、98.53%(67/68),差异均有统计学意义(P均<0.05);3D-CEUS判断子宫内膜癌病理分期符合率高于2D-CEUS[ⅠA期:100%(18/18) vs 77.78%(14/18),ⅠB期:100%(8/8) vs 87.50%(7/8);P均<0.05]。结论 3D-CEUS鉴别良恶性子宫内膜病变和判断内膜癌肌层浸润深度优于2D-CEUS,具有重要临床应用价值。 |
| 英文摘要: |
| Objective To investigate the value of three-dimensional contrast-enhanced ultrasonography (3D-CEUS) in differential diagnosis of benign and malignant endometrial lesions. Methods Data of 2D-CEUS and 3D-CEUS of 68 patients with endometrial lesions confirmed by pathology were restrospectively analyzed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 2D-CEUS and 3D-CEUS in diagnosing endometrial carcinoma were calculated and compared with pathological results as gold standard. The coincidence rate with pathological results in assessing the pathological stage of endometrial carcinoma were calculated and compared between 2D-CEUS and 3D-CEUS. Results Of 68 cases, there were 42 cases with benign endometrial lesions, including 19 of endometrial polyp, 10 of endometrial hyperplasia, 6 of cystic atrophic endometrium, 4 of uterine blood clot, 3 of submucous myoma, there were 26 cases of endometrial carcinoma. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing endometrial carcinoma was 76.92% (20/26), 73.81% (31/42), 64.52% (20/31), 83.78% (31/37), 75.00% (51/68) for 2D-CEUS and 100% (26/26), 97.62% (41/42), 96.30% (26/27), 100% (41/41), 98.53% (67/68) for 3D-CEUS (all P<0.05). 3D-CEUS had higher coincidence rate with pathological results in assessing the pathological stage compared with 2D-CEUS (ⅠA stage: 100% [18/18]vs 77.78%[14/18], ⅠB stage: 100% [8/8]vs 87.50%[7/8], both P<0.05). Conclusion 3D-CEUS has higher ability in differential diagnosis of benign and malignant endometrial lesions and assessment of endometrial cancer myometrial invasion, which is of important clinical application value. |
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