【摘要】 目的探讨超声特征及Adler血流分级在子宫平滑肌瘤(uterine leiomyoma,LM)、非典型平滑肌瘤(atypical leiomyoma,ALM)及子宫平滑肌肉瘤(leiomyosarcoma,LMS)中的诊断价值。方法回顾性分析2016年10月至2019年12月在山西医科大学第一医院妇科术后经病理检查诊断为LM、ALM及LMS的患者154例,根据病理检查结果分为3组,分析患者一般情况及超声特征,比较超声特征在3组疾病诊断中的差异性,并探索Adler血流分级在3组疾病的诊断价值。结果 LMS组患者平均初诊年龄高于LM组及ALM组,差异有统计学意义(P<0.05);3组患者在临床症状、血清CA 125、超声下瘤体平均直径、内部回声及结构等方面比较,差异均无统计学意义(P>0.05);LMS组瘤体边界不清晰、RI值低,差异有统计学意义(P<0.05);对瘤体内血流信号进行Adler血流分级,3组比较差异均有统计学意义(P<0.05);经ROC曲线分析显示超声结合Adler血流分级在诊断ALM及LMS中具有较好的临床价值,特异度(分别为93.2%、93.5%)均高于超声检查。结论彩色多普勒超声及Adler血流分级在LM、ALM及LMS组的鉴别诊断中具有一定的临床应用价值。更多还原

【Abstract】 Objective To explore the diagnostic value of ultrasound features and Adler blood flow classification in uterine leiomyoma(LM), atypical leiomyoma(ALM) and leiomyosarcoma(LMS). Methods A retrospective analysis of 154 patients who were diagnosed as LM, ALM and LMS by pathological examination in the Gynecology Department of the First Affiliated Hospital of Shanxi Medical University from October 2016 to December 2019 were divided into 3 groups according to the results of the pathological examination. Analyed the conditions and ultrasound characteristics, compared the differences of ultrasound features in the diagnosis of the 3 groups of diseases, and explored the diagnostic value of Adler blood flow classification in the 3 groups of diseases. Results The average age at first diagnosis of the LMS group was higher than that of the LM group and the ALM group, and the difference was statistically significant(P<0.05). The three groups of patients had clinical symptoms, serum CA 125, average tumor diameter under ultrasound, internal echo and structure, etc. The differences were not statistically significant(P>0.05); the tumor body boundary in the LMS group was not clear, the RI value was low, and the difference was statistically significant(P<0.05); Adler blood flow grading was performed on the blood flow signal in the tumor,the differences were statistically significant in the three groups(P<0.05); ROC curve analysis showed that ultrasound combined with Adler blood flow classification had good clinical value in the diagnosis of ALM and LMS, and the specificity(93.2% and 93.5%, respectively) was higher than Ultrasonography. Conclusion Color Doppler ultrasound and Adler blood flow classification have certain clinical application value in the differential diagnosis of LM, ALM and LMS groups.更多还原