子宫内膜息肉超声与病理诊断结果比较
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摘要
目的探讨经阴道彩色多普勒超声对子宫内膜息肉的诊断价值,提高诊断符合率。方法随访2016年1月—2017年10月诊断为子宫内膜息肉的患者,筛选经过宫腔镜手术具有病理诊断的病例,分析超声诊断与病理诊断的符合率。结果 262例患者中,病理诊断为子宫内膜息肉228例,经阴道超声的诊断符合率为87%,误诊34例,其中30例为正常子宫内膜。息肉组与正常组超声图像在病灶边缘是否清晰、病灶内是否探及血流信号等特征方面差异有统计学意义(P<0. 05)。多因素Logistic回归分析发现,超声提示病灶边界清晰、内探及血流信号的病例,超声与病理诊断符合率高。结论经阴道彩色多普勒超声诊断子宫内膜息肉符合率高,可以为临床诊断及治疗提供依据,超声提示边界清晰、内部检出血流的病例,病理诊断更倾向为子宫内膜息肉。
Objective To assess the value of transvaginal color Doppler sonography( TVCDS) in diagnosis of endometrial polyp. Methods Two hundred and sixty-two patients with ultrasounddiagnosed endometrial polyps from January 2016 to October 2017 were enrolled. Patients also underwent hysteroscopy and pathological examination,the diagnose accordance rate of ultrasonography with pathology was analyzed. Results Among 262 patients,diagnosis of endometrial polyps was confirmed by pathological examination in 228 cases with a coincidence was 87%; 34 cases were misdiagnosed including 30 cases of normal endometrium. There were significant differences in borderline and blood flow signal on ultrasonography between polyps and normal endometrium( P < 0. 05).Multivariate Logistic regression analysis showed that the coincidence rate of sonography with pathological examination was higher in cases with a clear boundary and blood flow signal shown in ultrasonograph.Conclusion Transvaginal color Doppler ultrasonography has a high diagnostic accordance with pathology,particularly in cases with clear borderline and blood flow signal displayed by ultrasonography.
Objective To assess the value of transvaginal color Doppler sonography( TVCDS) in diagnosis of endometrial polyp. Methods Two hundred and sixty-two patients with ultrasounddiagnosed endometrial polyps from January 2016 to October 2017 were enrolled. Patients also underwent hysteroscopy and pathological examination,the diagnose accordance rate of ultrasonography with pathology was analyzed. Results Among 262 patients,diagnosis of endometrial polyps was confirmed by pathological examination in 228 cases with a coincidence was 87%; 34 cases were misdiagnosed including 30 cases of normal endometrium. There were significant differences in borderline and blood flow signal on ultrasonography between polyps and normal endometrium( P < 0. 05).Multivariate Logistic regression analysis showed that the coincidence rate of sonography with pathological examination was higher in cases with a clear boundary and blood flow signal shown in ultrasonograph.Conclusion Transvaginal color Doppler ultrasonography has a high diagnostic accordance with pathology,particularly in cases with clear borderline and blood flow signal displayed by ultrasonography.
引文
[1]BEN-ARIE A,GOLDCHMIT C,LAVIV Y,et al.The malignant potential of endometrial polyps[J].Eur J Obstet Gynecol Reprod Biol,2004,115(2):206-210.
[2]刘雨声,郭银树,段华,等.绝经期子宫内膜息肉临床特点分析[J].中国微创外科杂志,2017,17(7):627-629.
[3]SHARMA M,TAYLOR A,MAGOS A.Management of endometrial polyps:a clinical review[J].Rev Gynaecol Pract,2004,4(1):1-6.
[4]谢红宁.妇产科超声诊断学[M].北京:人民卫生出版社,2005:225.
[5]任奇志.子宫内膜息肉对不孕患者临床妊娠的影响分析[J].临床医药文献电子杂志,2017,4(49):9541.
[6]KILICDAG E B,HAYDARDEDEOGLU B,COK T,et al.Polycystic ovary syndrome and increased polyp numbers as risk factors for malignant transformation of endometrial polyps in premenopausal women[J].Int JGynaecol Obstet,2011,112(3):200-203.
[7]黄海英.子宫内膜息肉发病相关高危因素的临床调查分析[J].中国医药科学,2018,8(18):167-170,192.
[8]唐华栋,王慧英,郝增平,等.子宫内膜息肉与异常子宫出血的相关特点分析[J].中国妇产科临床杂志,2014,15(1):29-32.
[9]新瑜,吴献.超声对子宫内膜息肉和黏膜下小肌瘤的鉴别诊断价值[J].中国现代医药杂志,2015,17(3):82-84.
[10]刘方方,贺其志,朱慧庭.子宫静脉内平滑肌瘤病病理特征[J].同济大学学报(医学版),2018,39(2):90-93,98.
[2]刘雨声,郭银树,段华,等.绝经期子宫内膜息肉临床特点分析[J].中国微创外科杂志,2017,17(7):627-629.
[3]SHARMA M,TAYLOR A,MAGOS A.Management of endometrial polyps:a clinical review[J].Rev Gynaecol Pract,2004,4(1):1-6.
[4]谢红宁.妇产科超声诊断学[M].北京:人民卫生出版社,2005:225.
[5]任奇志.子宫内膜息肉对不孕患者临床妊娠的影响分析[J].临床医药文献电子杂志,2017,4(49):9541.
[6]KILICDAG E B,HAYDARDEDEOGLU B,COK T,et al.Polycystic ovary syndrome and increased polyp numbers as risk factors for malignant transformation of endometrial polyps in premenopausal women[J].Int JGynaecol Obstet,2011,112(3):200-203.
[7]黄海英.子宫内膜息肉发病相关高危因素的临床调查分析[J].中国医药科学,2018,8(18):167-170,192.
[8]唐华栋,王慧英,郝增平,等.子宫内膜息肉与异常子宫出血的相关特点分析[J].中国妇产科临床杂志,2014,15(1):29-32.
[9]新瑜,吴献.超声对子宫内膜息肉和黏膜下小肌瘤的鉴别诊断价值[J].中国现代医药杂志,2015,17(3):82-84.
[10]刘方方,贺其志,朱慧庭.子宫静脉内平滑肌瘤病病理特征[J].同济大学学报(医学版),2018,39(2):90-93,98.