子宫内膜能量多普勒超声在国际子宫内膜肿瘤分析组分类中的作用预测宫内病理学。

Role of endometrial power Doppler ultrasound using the international endometrial tumor analysis group classification in predicting intrauterine pathology.

机构信息

Department of Obstetrics and Gynecology, Dumlupinar University Evliya Celebi Training and Research Hospital, Kutahya, Turkey.

出版信息

Arch Gynecol Obstet. 2013 Sep;288(3):649-54. doi: 10.1007/s00404-013-2813-0. Epub 2013 Mar 26.

DOI:10.1007/s00404-013-2813-0

PMID:23529686

Abstract

PURPOSE

To assess the contribution of the terms and definitions recently described by international endometrial tumor analysis (IETA) group when evaluating endometrial lesions on power Doppler imaging.

METHODS

Patients requiring endometrial sampling were examined prospectively by transvaginal B-mode and power Doppler sonography (PDS) the day before scheduled diagnostic procedure. Sonographic features were classified using IETA group classification. These were compared with the final histopathological diagnosis.

RESULTS

Ninety-seven patients were included in the study. The histopathological diagnoses were as follows: endometrial polyp: 39 cases (40.2 %), endometrial hyperplasia: 9 cases (9.3 %), submucous myoma: 10 cases (10.3 %), endometrium cancer: 7 cases (7.2 %), non-specific findings: 32 cases (33 %). The sensitivity, specificity and positive and negative predictive values for single dominant or branching single dominant vessel pattern in diagnosing endometrial polyps were 66.67, 98.28, 96.3 and 81.43 %; for multiple vessels with focal origin pattern in diagnosing endometrial cancer, they were 42.86, 91.11, 27.27 and 95.35 %; for multifocal origin at the myometrial-endometrial junction in diagnosing other non-specific endometria, they were 81.25, 89.23, 78.79 and 90.62 %; for scattered vessel pattern in diagnosing endometrial hyperplasia, they were 88.89, 88.64, 44.4 and 98.73 % and for circular flow pattern in diagnosing submucosal fibroids, they were 80, 100, 100 and 97.75 %, respectively. The color score of the endometrium was not statistically different among different endometrial pathologies (P value >0.05).

CONCLUSION

The nomenclature described by IETA group for power Doppler assessment of the endometrium is clinically valuable and reasonable. Using this terminology, it will be easier to compare results of different studies on endometrial Doppler sonography in the future.

摘要

目的

评估国际子宫内膜肿瘤分析（IETA）小组最近描述的术语和定义在评估子宫内膜病变的能量多普勒成像中的作用。

方法

前瞻性地对需要子宫内膜取样的患者进行经阴道 B 型和能量多普勒超声（PDS）检查，在预定的诊断程序前一天进行。使用 IETA 组分类对超声特征进行分类。将这些与最终的组织病理学诊断进行比较。

结果

共有 97 例患者纳入研究。组织病理学诊断如下：子宫内膜息肉：39 例（40.2%），子宫内膜增生：9 例（9.3%），黏膜下肌瘤：10 例（10.3%），子宫内膜癌：7 例（7.2%），非特异性发现：32 例（33%）。在诊断子宫内膜息肉时，单一主导或分支主导血管模式的敏感性、特异性、阳性预测值和阴性预测值分别为 66.67%、98.28%、96.3%和 81.43%；在诊断子宫内膜癌时，多灶起源点状模式的敏感性、特异性、阳性预测值和阴性预测值分别为 42.86%、91.11%、27.27%和 95.35%；在诊断其他非特异性子宫内膜时，多灶起源于子宫肌层-子宫内膜交界处的敏感性、特异性、阳性预测值和阴性预测值分别为 81.25%、89.23%、78.79%和 90.62%；在诊断子宫内膜增生时，散在血管模式的敏感性、特异性、阳性预测值和阴性预测值分别为 88.89%、88.64%、44.4%和 98.73%；在诊断黏膜下肌瘤时，环状血流模式的敏感性、特异性、阳性预测值和阴性预测值分别为 80%、100%、100%和 97.75%。不同子宫内膜病变之间的子宫内膜彩色评分无统计学差异（P 值>0.05）。