经阴道能量多普勒超声诊断在宫颈癌前病变中的应用价值

卜丹

[摘要]目的 探討经阴道能量多普勒超声诊断在宫颈癌前病变中的应用价值。方法 根据随机抽样法选取2016年4月～2018年4月在我院就诊的52例疑似宫颈癌前病变的女性患者作为观察组，选取同期在我院体检的女性健康体检者52例，作为对照组。两组均采用超声诊断，观察组之后进行阴道镜病理切片检查确诊。对比超声诊断和阴道镜的病理诊断结果，评估经阴道能量多普勒超声诊断宫颈癌前病变的应用价值。结果 在阴道镜病理诊断结果中，癌前病变25例，早期宫颈癌24例，宫颈炎症2例，宫颈肌瘤1例；在超声诊断结果中，癌前病变27例，早期宫颈癌25例。超声诊断的符合率为94.23%，误诊率为5.76%。与健康对照组女性相比，观察组患者的宫内血流信号显著增多。观察组患者的阻力指数（RI）指数（0.50±0.14）显著低于对照组（0.71±0.05），其脉收缩期峰值血流速度（PSV）[（10.68±6.85）cm/s]明显高于对照组[（8.50±4.47）cm/s]，差异有统计学意义（P<0.05）。观察组患者的血流信号分级情况优于对照组，差异有统计学意义（P<0.05）。结论 经阴道能量多普勒超声应用于宫颈癌前病变的诊断中，具有较高的诊断准确率，可清晰、客观地显示子宫内局部病变血流的分布情况，可作为临床诊断宫颈癌前病变的重要辅助检查手段。

[关键词]经阴道能量多普勒超声；宫颈癌前病变；应用价值

[中图分类号] R714.22 [文献标识码] A [文章编号] 1674-4721（2019）4（a）-0166-03

[Abstract] Objective To investigate the diagnostic value of transvaginal power Doppler ultrasound in cervical precancerous lesions. Methods A total of 52 female patients with suspected cervical precancerous lesions from April 2016 to April 2018 were selected by random sampling as the study group， and 52 female healthy examinees in our hospital during the same period were selected as control group. The two groups were diagnosed by ultrasound， and the observation group was diagnosed by colposcopy biopsy. The value of transvaginal power Doppler ultrasonography in the diagnosis of cervical precancerous lesions were evaluated by comparing the results of ultrasonography and colposcopy pathology. Results Among the results of colposcopic pathological diagnosis， 25 cases were precancerous lesions， 24 cases were early cervical cancer， 2 cases were cervical inflammation and 1 case was cervical myoma. Among the results of ultrasound diagnosis， 27 cases were precancerous lesions， 25 cases were early cervical cancer， the coincidence rate of ultrasound diagnosis was 94.23%， and the misdiagnosis rate was 5.76%. Compared with healthy controls， intrauterine blood flow signals in the observation group increased significantly. The resistance index （RI） of the observation group （0.50±0.14） was significantly lower than that of the control group （0.71±0.05）， the peak systolic blood flow velocity （PSV） of the observation group （[10.68±6.85] cm/s） was significantly higher than that of the control group （[8.50±4.47] cm/s）， with statistical significance （P<0.05）. The grading of blood flow signals in the observation group was better than that in the control group， with statistical significance （P<0.05）. Conclusion Transvaginal power Doppler ultrasound has a high diagnostic accuracy in the diagnosis of cervical precancerous lesions. It can clearly and objectively display the blood flow distribution of local lesions in uterus， and can be used as an important auxiliary means for clinical diagnosis of cervical precancerous lesions.