| 摘要: |
| 目的：探讨彩色多普勒超声对子宫肉瘤的诊断价值。方法：选取2016年 1月至2022年8月期间在陆军军医大学第二附属医院妇产科经病理确诊的子宫肉瘤患者40例,并随机选取同期病理证实的子宫肌瘤患者50例作为对照,回顾性分析其超声声像图特征及相关临床资料。结果：①子宫肉瘤患者发病年龄、CA125高于子宫肌瘤,差异有统计学意义。子宫肉瘤患者多表现为绝经后阴道流血,下腹部坠胀不适等症状。②子宫肉瘤与子宫肌瘤两组病例在病灶数目、大小、边界、形态、内部回声及部位分布比较均有统计学差异(P＜0.05),子宫肉瘤多表现为单发,体积较大,边界不清晰、形态不规则,内部回声呈不均质低回声、实性杂乱回声、囊实混合性或蜂窝样回声。子宫肉瘤和子宫肌瘤两组病例在病灶的血流分布、血流丰富程度比较差异有统计学意义(P<0.001),子宫肉瘤多病灶内部血流丰富,而肌瘤多病灶周边分布规则点条状血流。③40例子宫肉瘤患者术前超声诊断子宫肿瘤(恶性可能)23例,子宫肉瘤1例,子宫内膜癌4例,宫颈癌1例,子宫肌瘤9例(2例伴变性可能),血管平滑肌瘤1例,脉管平滑肌瘤1例。术后病理证实子宫平滑肌肉瘤11例,子宫内膜间质肉瘤20例,癌肉瘤8例,骨外Ewing肉瘤1例。结论 彩色多普勒超声对子宫肉瘤具有较高的临床应用价值,充分认识子宫肉瘤的声像图特征,并结合临床资料综合分析,有利于提高诊断准确率。 |
| 关键词: 子宫肉瘤 子宫肌瘤 超声检查 |
| DOI： |
| 投稿时间：2024-04-25修订日期：2024-05-25 |
| 基金项目:重庆市科卫联合重点项目（2018ZDXM034） |
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| Clinical application value of color Doppler ultrasound in uterine sarcoma |
| 邓凤莲,xiongxi,gaochunyan,zhangyue,hewenjiao,zhangqiyuan |
| (disanjunyidaxuefushueryuan) |
| Abstract: |
| Objective: To investigate the diagnostic value of color Doppler ultrasound in uterine sarcoma. Methods: A total of 40 patients with uterine sarcoma confirmed pathologically in the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Army Military Medical University from January 2016 to August 2022 were selected, and 50 patients with uterine fibroids confirmed pathologically during the same period were randomly selected as controls. The ultrasonographic characteristics and related clinical data were retrospectively analyzed. Results: ① The onset age and CA125 of patients with uterine sarcoma were higher than those with uterine fibroids, and the difference was statistically significant. Uterine sarcoma patients with postmenopausal vaginal bleeding, lower abdominal swelling discomfort and other symptoms. ② There were statistical differences in the number, size, boundary, shape, internal echo and site distribution between the two groups of uterine sarcoma and uterine fibroids (P < 0.05). Uterine sarcoma was mostly single, large in volume, unclear boundary, irregular in shape, and internal echo presented uneven hypoecho, solid chaotic echo, mixed cyst solid or honeycomb echo. There were statistically significant differences in blood flow distribution and blood flow richness between the two groups (P<0.001). There was abundant blood flow inside the multiple lesions of uterine sarcoma, while regular point strip blood flow was distributed around the multiple lesions of fibroids. ③ Among 40 patients with uterine sarcoma, preoperative ultrasonographic diagnosis was made in 23 cases of uterine tumor (probable malignancy), 1 case of uterine sarcoma, 4 cases of endometrial cancer, 1 case of cervical cancer, 9 cases of uterine fibroids (2 cases with probable degeneration), 1 case of vascular leiomyoma, and 1 case of vascular leiomyoma. Postoperative pathology confirmed uterine leiomyosarcoma in 11 cases, endometrial stromal sarcoma in 20 cases, carcinosarcoma in 8 cases, and extraosseous Ewing sarcoma in 1 case. Conclusion：Color Doppler ultrasound has high clinical application value in uterine sarcoma, fully understanding the ultrasonographic characteristics of uterine sarcoma, combined with clinical data comprehensive analysis, is conducive to improve the diagnostic accuracy. |
| Key words: uterine sarcoma Uterine fibroids Ultrasonography diagnosis |
