彩色多普勒超声诊断子宫癌肉瘤的临床价值

发布时间：2018-01-25 21:00

本文关键词： 子宫癌肉瘤彩色多普勒超声经阴道超声　出处：《复旦学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨彩色多普勒超声诊断子宫癌肉瘤的临床应用价值。方法回顾性分析2003年1月至2014年12月间63例经手术病理证实的子宫癌肉瘤患者临床病史和超声图像特点,总结临床和超声图像特点并根据其超声图像特征进行分型。结果子宫癌肉瘤主要发生在绝经后妇女(77.8%),平均(57.7±11.5)岁。临床症状主要表现为绝经后阴道流血(57.1%)、月经失调(20.6%)、阴道排液(11.1%)、发现子宫包块或内膜增厚(11.1%)。36例检查血清CA125水平,其中21例(58.3%)属正常范围,9例(25%)患者CA125水平稍高于正常值(41.6~200 U/mL),6例(16.7%)晚期或伴卵巢恶性病变患者CA125水平较高(200 U/mL)。子宫癌肉瘤超声表现分为宫腔型(71.4%)、肌层型(14.3%)和内膜型(14.3%)。宫腔型和肌层型病变的共同超声图像特征为病灶边界不清、形态不规则、内部不均匀,彩色多普勒超声显示病灶周边及内部有低阻力指数(0.55±0.11)的丰富彩色血流信号分布,其中肌层型的特征性表现为肌层较大体积病变。结论子宫癌肉瘤为罕见的高侵袭性子宫恶性肿瘤,临床主要表现为绝经后阴道流血、月经失调、阴道排液等,超声表现为宫腔型、肌层型和内膜增厚型。加强对子宫癌肉瘤的认识,结合临床表现和经阴道彩色多普勒超声检查有助于早期诊断子宫癌肉瘤并选择合适的治疗方案。
[Abstract]:Objective to evaluate the clinical value of color Doppler ultrasonography in the diagnosis of uterine carcinosarcoma. Methods 63 cases of uterine carcinosarcoma confirmed by surgery and pathology from January 2003 to December 2014 were retrospectively analyzed. History and ultrasonographic features. The clinical and ultrasonographic features were summarized and classified according to the characteristics of ultrasound images. Results uterine carcinosarcoma mainly occurred in postmenopausal women (77.8%). The average age was 57.7 卤11.5 years old. The main clinical symptoms were postmenopausal vaginal bleeding (57.1%), menstrual disorders (20.6%) and vaginal drainage (11.1%). It was found that the serum CA125 level was detected in 36 cases with uterine mass or endometrial thickening, of which 21 cases (58.3%) were within the normal range. The CA125 level of 9 patients was slightly higher than the normal value of 41.6 ~ 200 U / mL). The CA125 level of 6 patients with advanced or malignant ovarian lesions was higher than 200 U / mL. The ultrasonographic findings of uterine carcinoma and sarcoma were divided into uterine cavity type (71.4). The common ultrasonographic features of uterine cavity type and myometrium type lesions were unclear boundary irregular shape and uneven interior. Color Doppler ultrasound showed the distribution of rich color blood flow signals with low resistive index (0.55 卤0.11) around and inside the lesion. Conclusion uterine carcinosarcoma is a rare highly invasive malignant tumor of the uterus. The main clinical manifestations are postmenopausal vaginal bleeding, menstrual disorders, vaginal effusion and so on. Ultrasonographic manifestations were uterine cavity type, myometrial type and intimal thickening type. The combination of clinical manifestations and transvaginal color Doppler ultrasonography is helpful to early diagnosis of uterine carcinosarcoma and selection of appropriate treatment.
【作者单位】：复旦大学附属妇产科医院超声诊断科;
【分类号】：R445.1;R737.33
【正文快照】： 子宫癌肉瘤(uterine carcinosarcoma,UCS)又称子宫恶性苗勒管混合瘤(malignant mixed Mülleriantumor,MMMT),是一种罕见但侵袭性极高的子宫体恶性肿瘤,占所有子宫恶性肿瘤的5%以下,预后差[1]。研究报道肿瘤大小、手术-病理分期是其独立的预后影响因素,因此早期发现、早期诊断

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