目的:应用彩色多普勒超声(CDFI)观察与分析绝经后增厚子宫内膜区动脉血流参数变化与内膜病变的相关性.方法:2008年1月～2012年1月158例绝经后子宫内膜增厚并最终获得病理的患者纳入研究,完成经阴道CDFI检查,测定增厚内膜区动脉血流,分析能量图与收缩期峰值流速(PSV)、舒张末血流最低参数(EDV)和阻力指数(RI).结果:子宫内膜癌36例,内膜区见多条异常增粗的血管,血流信号增多紊乱,CDFI 显示PSV(28±5.1)cm/s,与良性病变(24.6±3.0cm/s)无明显差异；EDV为(16±3.8)cm/s,明显高于良性病变(7.3±2.5cm/s,P＜0.05);血流阻力指数(RI＜0.43)则明显低于良性病变(RI＞0.5).子宫内膜良性病变122例,其中31例子宫内膜息肉内膜区单根血管延伸至瘤体,CDFI显示低速高阻血流(RI＞0.56); 35例子宫黏膜下肌瘤内膜区显示环状血流信号,CDFI显示低速高阻血流(RI＞0.5); 14例子宫内膜增生反应显示内膜区血流信号呈细条状,CDFI显示低速高阻血流(RI＞0.68);21例子宫内膜增生反应无血流信号.结论:均匀增厚的内膜内高阻血流的存在是诊断内膜良性病变的关键,而异常增厚内膜内舒张期增高低阻血流的存在是恶性病变的一项重要指标.通过子宫内膜血流的CDFI检测可以帮助鉴别子宫内膜病变的良、恶性.%Purpose: To observe the application of color Doppler imaging (CDFI) in diagnosis of postmenopausal endometrial thickening, and to evaluate the correlation between the blood flow parameters change and the pathology changes of the intimal lesion. Methods: From January 2008 to January 2012, 158 cases of postmenopausal endometrial thickening patients with pathology diagnosis were included in the study. Transvaginal CDFI examination was used to evaluate the arterial blood flow of the thickened intimal area. The energy diagram and contraction of peak velocity (PSV), the lowest parameters diastolic of end velocity (EDV) and resistance index (RI) were analyzed. Results: Of all the cases, 36 cases were endometrial cancers, abnormal thickening of the blood vessels, increase of blood flow signals disorders were shown in the endometrial areas, the PSV was 28 ±5.1cm / s on CDFI, and was with no significant statistical difference between them and that of benign lesions (24.6 ±3.0cm / s) ; the EDV was 16 ±3.8cm / s, that was significantly higher than that of benign lesions (7.3 ±2.5cm / s, P <0.05); flow resistance index (RI <0.43) was significantly lower than that of benign lesions (RI> 0.5). Of 122 cases of endometrial benign lesions, 31 cases were endometrial polyps, the features of them included single vascular extension from endometrial area to the tumor, low-speed high resistance blood flow (RI> 0.56) on CDFI; 35 cases were uterine submucosal fibroids, the features indued circumferential blood flow signals, and low-speed high-impedance blood flow (RI> 0.5) on CDFI; 14 cases were endometrial hyperplasia reaction, the features included thin strips blood flow signal in intimal areas , and low-speed high-impedance blood flow (RI> 0.68) on CDFI; 21 cases were uterine intimal hyperplasia reaction, no blood flow was shown in them. Conclusion: The high resistance blood flow in the presence of a uniform thickening of the intima is the key to the diagnosis of benign endometrial lesions; abnormal thickening of the intima combined with the increase of diastolic low resistance blood flow is an important indicator of the malignant lesions. By CDFI, detection of endometrial blood flow can help the identification of endometrial lesions, and to differentiate benign lesions from malignant.iu0000h
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