彩超在子宫肌瘤与子宫腺肌症的诊断与鉴别诊断中的诊断价值

彩超在子宫肌瘤与子宫腺肌症的诊断与鉴别诊断中的诊断价

值

摘要：目的探讨彩超在子宫肌瘤与子宫腺肌症的诊断与鉴别诊断中的临床应用

价值。方法选择2015年11月～2017年11月期间我院行彩超检查的子宫肌瘤患

者30例作为A组，另选取同期行彩超检查的子宫腺肌症患者26例为B组，比较

两组的超声声像图表现及采用多普勒测量子宫动脉阻力指数（RI）、搏动指数（PI）和血流量（BFV）。结果 30子宫肌瘤患者超声声像图表现为子宫增大，其

中均匀增大11例。低回声25例，等回声4例，高回声1例，以低回声为主。包

块边界清晰25例。内膜线向后偏移4例，向前偏移5例，非同向偏移1例。CDFI示：包块内显示星状或条状血流信号12例。26例子宫腺肌症患者超声声像

图主要表现：患者的子宫轻度弥漫性增大，24例子宫边界不清晰，光点粗大，低

回声21例，高回声5例，以高回声为主。CDFI示：病灶区内血流少，见稀疏的

短条状血流。局限性病灶周围未见环状或半环状血流信号环绕。A组的RI 显著低

于B组，但PI 及BFV显著高于B组，差异有统计学意义（P<0.05）。结论彩色

多普勒超声对子宫肌瘤与子宫腺肌症具有重要的诊断与鉴别诊断价值，可以为子

宫腺肌病与子宫肌瘤的诊断提供可靠的参考依据。

关键词：子宫肌瘤；子宫腺肌症；彩色多普勒超声；诊断；鉴别诊断

[abstract] Objective To explore the clinical value of color Doppler ultrasonography

in the diagnosis and differential diagnosis of uterine leiomyoma and

adenomyosis.Methods Thirty patients with uterine fibroids who underwent color Doppler ultrasonography from November 2015 to November 2017 were selected as group A，and 26 patients with adenomyosis who underwent color Doppler ultrasonography at the same time were selected as group B.The ultrasonographic features of the two groups were compared，and the resistance index（RI），pulsation index（PI）and blood flow（BFV）of uterine artery were measured by Doppler.Results Ultrasonographic findings of 30 patients with uterine leiomyoma were enlargement of uterus，of which 11 cases were enlarged evenly.There were 25 cases

of hypoechoic，4 cases of isoechoic and 1 case of hyperechoic.The boundary of mass was clear in 25 cases.Intimal line migrated backward in 4 cases，forward in 5 cases

and non-isotropic in 1 case.CDFI showed stellate or strip blood flow signals in 12 cases.The main sonographic manifestations of 26 cases of adenomyosis were mild diffuse enlargement of uterus，unclear uterine boundary in 24 cases，large light spot，21 cases of hypoechoic，5 cases of hyperechoic，mainly hyperechoic.CDFI showed

that there was little blood flow and sparse short strip blood flow in the lesion area.No circumferential or semi-circumferential blood flow signals were found around the focal lesions.RI in group A was significantly lower than that in group B，but PI and BFV were significantly higher than those in group B，with statistical significance（P <

0.05）.Conclusion Color Doppler ultrasound has important diagnostic and differential diagnostic value for uterine leiomyoma and adenomyosis，and can provide reliable reference for the diagnosis of adenomyosis and uterine leiomyoma.

[keywords] uterine leiomyoma；adenomyosis；color Doppler ultrasound；diagnosis；differential diagnosis