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    经腹超声造影对子宫肌层良性病变的诊断价值

    Diagnostic value of transabdominal contrast-enhanced ultrasound in benign myometrial lesions of the uterus

      摘要
    • 摘要: 目的 探讨经腹超声造影（CEUS）诊断子宫肌层良性病变的价值。方法 随机选择2022年9月-2023年8月在徐州市中心医院接受超声（US）及CEUS检查的子宫腺肌病、子宫肌瘤患者各50例，观察并比较子宫腺肌病及子宫肌瘤的CEUS增强方式、增强程度、消退方式、增强均匀度、增强后边界等定性指标，以及达峰时间（TTP）、峰值强度（PI）、平均渡越时间（MTT）等定量指标；构建受试者工作特征曲线（ROC），获得曲线下面积（AUC），比较US和CEUS的诊断效能（敏感度、特异度、阳性预测值、阴性预测值、准确度）。结果 所有患者经US检出子宫腺肌病38例，子宫肌瘤40例，诊断符合率78%；经CEUS检出子宫腺肌病48例，子宫肌瘤47例，诊断符合率95%。子宫腺肌病与子宫肌瘤的增强均匀度、增强后边界及消退方式比较，差异有统计学意义（P<0.05）；增强方式及增强程度比较，差异无统计学意义（P>0.05）。子宫腺肌病TTP为（39.72±5.72）s，短于子宫肌瘤TTP（43.26±5.01）s，PI为（70.11±4.58）%，低于子宫肌瘤PI（75.84±4.17）%，差异有统计学意义（P<0.05）；子宫腺肌病与子宫肌瘤的MTT分别为（85.54±6.16）s、（83.73±5.83）s，两者比较差异无统计学意义（P>0.05）。US的AUC为0.78，CEUS的AUC为0.95；CEUS诊断子宫腺肌病的敏感度、特异度、阳性预测值、阴性预测值、准确度均优于US，差异均有统计学意义（P<0.05）。结论 CEUS有助于诊断子宫腺肌病和子宫肌瘤，能够有效提升诊断结果的准确性，具有临床应用价值。

       

      Abstract: Objective To explore the diagnostic value of transabdominal contrast-enhanced ultrasound (CEUS) in benign myometrial lesions of the uterus.Methods A total of 50 adenomyosis patients and 50 hysteromyoma patients who were subject to ultrasound (US) and CEUS in Xuzhou Central Hospital from September 2022 to August 2023 were selected. Their qualitative indexes including the enhancement mode, enhancement degree, regression mode, enhancement uniformity and enhanced boundary, as well as quantitative indexes including time to peak (TTP), peak intensity (PI) and mean transit time (MTT) were observed and compared. A receiver operating characteristic (ROC) curve was constructed, obtaining the area under the curve (AUC) and the diagnostic efficiency such as sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US and CEUS was compared.Results Through US, 38 cases of adenomyosis and 40 cases of hysteromyoma were diagnosed, with a diagnostic consistent rate of 78%. Through CEUS, 48 cases of adenomyosis and 47 cases of hysteromyoma were diagnosed, with a diagnostic consistent rate of 95%. There were significant differences between adenomyosis and hysteromyoma in enhancement uniformity, boundary after enhancement and regression mode (P<0.05). There were no statistical differences in enhancement mode or enhancement degree (P>0.05). The TTP of adenomyosis was (39.72±5.72) s, which was shorter than (43.26±5.01) s for hysteromyoma, and the PI of adenomyosis was (70.11±4.58)%, which was lower than (75.84±4.17)% for hysteromyoma, with statistical significances (P<0.05). The MTT of adenomyosis and hysteromyoma was (85.54±6.16) s and (83.73±5.83) s respectively, without statistical difference (P>0.05). The AUC of US and CEUS was 0.78 and 0.95, respectively. CEUS showed better sensitivity, specificity, positive predictive value, negative predictive value and accuracy than CEUS in diagnosing adenomyosis, with statistical differences (P<0.05).Conclusions CEUS is useful to diagnose adenomyosis and hysteromyoma, and can effectively improve the accuracy of diagnosis results, with clinical application value.

       

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