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目的探究经阴道三维超声对绝经后子宫内膜良恶性病变的诊断价值。方法研究选择2015年5月—2016年5月在本院进行住院治疗的子宫内膜病变患者92例(均经病例手术确诊),应用经阴道三维超声进行检查,比较经阴道超声和病理检查结果,同时按病理结果分成良性组和恶性组,比较两组患者的子宫动脉收缩期峰值流速(peak systolic velocity,PSV)、阻力指数(resistance index,RI)、内膜动脉收缩期峰值流速(PSVen)、内膜动脉阻力指数(RIen)及血流显示率,计量资料之间比较采用t检验,计数资料应用χ2检验,P<0.05为差异有统计学意义。结果经阴道多普勒超声检查子宫内膜阳性患者共23例,均显示为子宫内膜不均匀增厚,且厚度超过10 mm,内部和肌层周边显示有杂乱的血流信号。经阴道超声检查的正确率为91.30%,灵敏度为92.00%,特异度为91.04%,良、恶性组患者检查的PSVen对比差异无统计学意义(P>0.05);良性组患者的RIen和血流显示均较恶性组差别显著[(0.45±0.10)、(0.37±0.05)、17.91%、96.00%],对比差异有统计学意义(P<0.05);恶性组患者的内膜厚度显著厚于良性组[(11.33±2.42)、(8.65±1.92)mm],对比差异有统计学意义(P<0.05);两组患者的PSV和RI的水平对比差异均无统计学意义(均P>0.05)。结论经阴道多普勒超声在诊断绝经后子宫内膜良、恶性病变的性质上有着较高的正确率和灵敏度,同时诊断子宫内膜恶性病变的特征对临床有着一定的应用价值,值得临床上广泛应用。
Objective To investigate the value of transvaginal three-dimensional ultrasound in the diagnosis of benign and malignant endometrial lesions after menopause. Methods A total of 92 patients with endometriosis who were hospitalized in our hospital from May 2015 to May 2016 were diagnosed by operation and transvaginal three-dimensional ultrasonography was performed. Transvaginal sonography and pathology were compared The patients were divided into benign group and malignant group according to the pathological results. The peak systolic velocity (PSV), resistance index (RI), peak systolic velocity (PSVen) , RIen (intima-arterial resistance index) and the rate of blood flow were detected. The t-test was used to compare the measurement data. The count data were analyzed byχ2 test. P <0.05 was considered as statistically significant. Results Transvaginal Doppler ultrasound examination of endometrial positive patients a total of 23 cases, showed uneven endometrial thickening, and the thickness of more than 10 mm, the internal and muscular layer showed a messy blood flow signal. The correct rate of transvaginal ultrasonography was 91.30%, the sensitivity was 92.00% and the specificity was 91.04%. There was no significant difference in PSVen between benign and malignant groups (P> 0.05). RIen and blood flow in benign group (0.45 ± 0.10), (0.37 ± 0.05), 17.91%, 96.00%], the difference was statistically significant (P <0.05); the thickness of the intima of the malignant group was significantly thicker than that of the benign (11.33 ± 2.42), (8.65 ± 1.92) mm respectively, there was significant difference between the two groups (P <0.05). There was no significant difference in PSV and RI between the two groups (all P> 0.05) . Conclusion Transvaginal Doppler ultrasound in the diagnosis of postmenopausal women with benign and malignant lesions of the nature of the high accuracy and sensitivity, while the diagnosis of endometrial malignant lesions of the characteristics of clinical application has some value, it is clinically widely used.