Botsis D, Kassanos D, Antoniou G, Pyrgiotis E, Karakitsos P, Kalogirou D
2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece.
J Clin Ultrasound. 1998 Jan;26(1):21-5. doi: 10.1002/(sici)1097-0096(199801)26:1<21::aid-jcu5>3.0.co;2-l.
The purpose of this study was to evaluate the capability of transvaginal sonography to differentiate adenomyomas from leiomyomas.
Two hundred six patients scheduled for surgery for symptomatic uterine masses underwent preoperative transvaginal sonography. Sonographic findings were compared with pathologic findings. Pathologic findings showed that 111 patients had leiomyomas, 48 had diffuse adenomyosis, 31 had adenomyomas, and 4 had leiomyosarcomas.
For the diagnosis of adenomyoma, transvaginal sonography demonstrated a sensitivity of 82.0%, specificity of 88.3%, positive predictive value of 84.6%, and negative predictive value of 87.5% compared with a sensitivity of 95.1%, specificity of 82.0%, positive predictive value of 90.7%, and negative predictive value of 85.7% for the diagnosis of leiomyoma. Two sonographic characteristics, lesion margin (p = 0.0001) and lacunae (p = 0.0001), allowed the differentiation of adenomyoma from leiomyoma.
Transvaginal sonography is an effective procedure for the preoperative differentiation of adenomyoma from leiomyoma. If the status of the lesion's margins and the presence or absence of hypoechoic lacunae were selected for analysis, leiomyomas could be correctly diagnosed with transvaginal sonography in 95% of cases.
本研究的目的是评估经阴道超声鉴别子宫腺肌瘤和平滑肌瘤的能力。
206例因有症状的子宫肿物而计划手术的患者接受了术前经阴道超声检查。将超声检查结果与病理结果进行比较。病理结果显示，111例患者患有平滑肌瘤，48例患有弥漫性子宫腺肌病，31例患有子宫腺肌瘤，4例患有平滑肌肉瘤。
对于子宫腺肌瘤的诊断，经阴道超声显示其敏感性为82.0%，特异性为88.3%，阳性预测值为84.6%，阴性预测值为87.5%；而对于平滑肌瘤的诊断，其敏感性为95.1%，特异性为82.0%，阳性预测值为90.7%，阴性预测值为85.7%。两个超声特征，即病变边界（p = 0.0001）和腔隙（p = 0.0001），有助于子宫腺肌瘤与平滑肌瘤的鉴别。
经阴道超声是术前鉴别子宫腺肌瘤与平滑肌瘤的有效方法。如果选择分析病变边界情况以及有无低回声腔隙，则经阴道超声在95%的病例中能正确诊断平滑肌瘤。
