超声造影在不同类型子宫肌瘤诊断中的应用

摘要

目的 比较超声造影(CEUS)与常规超声在不同类型子宫肌瘤定性及定位诊断中的价值.方法 采用实时CEUS技术对56例不同类型子宫肌瘤进行观察,以病理为金标准,回顾性分析CEUS定性及定位诊断不同类型子宫肌瘤的准确性,并与常规超声比较.结果 CEUS与常规超声诊断肌瘤的总体符合率、肌壁间肌瘤符合率、黏膜下肌瘤和浆膜下肌瘤符合率分别为94.6%(53/56),73.2%(41/56);99.3%(31/32),78.1%(25/32);91.6%(22/24),66.7%(16/24).CEUS和常规超声显示总的肌瘤的数目及肌瘤边界清晰情况分别为92.8%(104/112),80.3%(90/112),91.9%(103/112),78.6%(88/112).CEUS和常规超声对典型子宫肌瘤的诊断符合率分别为95.8%(23/24),87.5%(21/24);对不典型子宫肌瘤的诊断符合率分别为93.8%(30/32),62.5%(20/32).两组结果相比较,差异均有统计学意义(P<0.05).结论 CEUS可以更好地显示子宫肌瘤的数目及边界,对不同类型及不典型子宫肌瘤的诊断符合率明显高于常规超声,可为子宫肌瘤的定性及定位诊断提供一种新方法.%Objective To compare the value of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (CUS) in the localization and definition of different types of uterine myomas.Methods With real-time CEUS technique, 56 patients with uterine myomas proved by pathology were observed. The accuracy between CEUS and CUS in the localization and definition of different types of uterine myomas was retrospectively analyzed. Results The accordance rates of CEUS and CUS in the diagnosis of total uterine myomas, intramural myomas, submueous and subserous myomas were 94.6% (53/56) vs 73.2%(41/56),99.3%(31/32) vs 78.1%(25/32) and 91.6%(22/24) vs 66.7%(16/24),respectively,and in the definition of number and margin of myomas were 92.8 % (104/112) vs 80.30% (90/112) and 91.9 (103/112) vs 78.6 % (88/112). The accordance rates of CEUS and CUS in the diagnosis of typical uterine myomas were 95.8% (23/24) and 87.5% (21/24),and in the diagnosis of atypical uterine myomas were 93.8%(30/32) and 62.5% (20/32),which were different in statistics (P<0.05). Conclusions CEUS is better than CUS in revealing the number and margin of different types of uterine myomas. The accordance rates of CEUS were higher than those of CUS in the diagnosis of different types of uterine myomas and atypical uterine myomas. CEUS may be a new technique in the localization and definition of uterine myomas.