Kurjak A, Shalan H, Sosic A, Benic S, Zudenigo D, Kupesic S, Predanic M
Ultrasonic Institute Medical School, University of Zagreb, Croatia.
Am J Obstet Gynecol. 1993 Dec;169(6):1597-603. doi: 10.1016/0002-9378(93)90443-m.
This study was conducted to evaluate the role of transvaginal color Doppler ultrasonography in detecting endometrial carcinoma in postmenopausal women and in evaluating the depth of myometrial invasion and tumor staging.
A group of 750 postmenopausal women were examined by transvaginal color Doppler ultrasonography 1 day before the planned hysterectomy. Histopathologic and blood flow characteristics were evaluated. Analysis of variance was used to test the significance among the subgroups.
Thirty-five women had endometrial carcinoma; 32 (91.4%) cases were detected by transvaginal color Doppler ultrasonography. Visualization of abnormal blood flow within the endometrium was 100% in the diagnosed cases with resistance index near or < 0.40, which constituted a statistically significant difference compared with that of endometrial hyperplasia. No flow was detected in normal, atrophic, and in 92% of cases with hyperplastic endometria. The color Doppler ultrasonography depicted 18 of 19 histologically proved cases of myometrial invasion. Three asymptomatic cases were discovered on the basis of morphologic and blood flow patterns.
Transvaginal color Doppler ultrasonography can depict endometrial carcinoma, even in asymptomatic women, determine the depth of myometrial invasion, and help in tumor staging.
本研究旨在评估经阴道彩色多普勒超声检查在绝经后妇女子宫内膜癌检测中的作用，以及评估肌层浸润深度和肿瘤分期。
一组750名绝经后妇女在计划进行子宫切除术的前一天接受经阴道彩色多普勒超声检查。对组织病理学和血流特征进行评估。采用方差分析来检验各亚组之间的显著性。
35名妇女患有子宫内膜癌；经阴道彩色多普勒超声检查检测出32例（91.4%）。在诊断病例中，子宫内膜内异常血流的可视化率为100%，阻力指数接近或<0.40，与子宫内膜增生相比，这构成了统计学上的显著差异。在正常、萎缩性子宫内膜以及92%的增生性子宫内膜病例中未检测到血流。彩色多普勒超声检查显示了19例经组织学证实的肌层浸润病例中的18例。基于形态学和血流模式发现了3例无症状病例。
经阴道彩色多普勒超声检查即使在无症状妇女中也能检测出子宫内膜癌，确定肌层浸润深度，并有助于肿瘤分期。
