Cantuaria G H, Angioli R, Frost L, Duncan R, Penalver M A
Department of Obstetrics and Gynecology, University of Miami, Florida, USA.
Obstet Gynecol. 1998 Jul;92(1):109-12. doi: 10.1016/s0029-7844(98)00131-8.
To correlate the preoperative bimanual examination with ultrasound examination with regard to estimating the size of enlarged nongravid leiomyomatous uteri.
We performed a retrospective review of 161 patients who underwent hysterectomy for uterine leiomyoma between January 1994 and December 1994 and between July 1995 and April 1996. Uterine size was estimated clinically by bimanual examination. Ultrasound reports were reviewed. Uterine weights and dimensions in pathology reports were compared with findings on bimanual examination and ultrasonography. Body mass index (BMI) was calculated and patients were divided into two groups, one with BMIs of more than 30 and another with BMIs of less than or equal to 30.
Ultrasound examination was ordered in 111 patients (68.9%) preoperatively. There was a strong correlation between the bimanual examination findings and the ultrasound dimensions. The equation for this relationship is ultrasound length (cm)=3.68 + 0.68 x number of weeks (r=.78, P < .001). Ultrasound length also was related strongly to size given in the pathologic reports; the equation for this relationship is ultrasound length (cm)=2.94 + 0.75 x pathology length (cm) (r=.73, P < .001). The correlation between bimanual examination and ultrasound findings was similar in obese and in nonobese patients, when uterine size could be estimated.
There is a strong correlation between bimanual and ultrasound examinations with regard to determining the size of leiomyomatous uteri. Routine ultrasound is not indicated when an experienced examiner can assess uterine size. Ultrasonography may be appropriate when physical assessment is difficult, as in the case of obesity.
探讨术前双合诊检查与超声检查在评估非妊娠子宫平滑肌瘤增大子宫大小方面的相关性。
我们对1994年1月至1994年12月以及1995年7月至1996年4月期间因子宫平滑肌瘤接受子宫切除术的161例患者进行了回顾性研究。通过双合诊检查临床评估子宫大小。查阅超声报告。将病理报告中的子宫重量和尺寸与双合诊检查及超声检查结果进行比较。计算体重指数（BMI），并将患者分为两组，一组BMI大于30，另一组BMI小于或等于30。
111例患者（68.9%）术前接受了超声检查。双合诊检查结果与超声测量尺寸之间存在很强的相关性。这种关系的方程为超声长度（cm）=3.68 + 0.68×孕周数（r = 0.78，P < 0.001）。超声长度也与病理报告中给出的大小密切相关；这种关系的方程为超声长度（cm）=2.94 + 0.75×病理长度（cm）（r = 0.73，P < 0.001）。在能够估计子宫大小的肥胖和非肥胖患者中，双合诊检查与超声检查结果之间的相关性相似。
在确定子宫平滑肌瘤子宫大小方面，双合诊检查与超声检查之间存在很强的相关性。当有经验的检查者能够评估子宫大小时，无需常规进行超声检查。在体格检查困难的情况下，如肥胖患者，超声检查可能是合适的。
