经阴道超声与CT扫描在诊断子宫肌瘤中的应用价值比较

王照宇

[摘要] 目的 探讨经阴道超声与CT扫描在诊断子宫肌瘤中的应用价值。 方法 选取我院2017年6月至2019年6月收治的136例子宫肌瘤患者的临床资料进行分析，均采用阴道超声与CT扫描检查，比较两种方法诊断子宫肌瘤符合率，对肌瘤数目、边界、变性检出率及误诊情况。 结果 CT扫描对肌壁间肌瘤诊断符合率为100.00%、子宫肌瘤总诊断符合率为95.59%，高于经阴道超声检查的86.30%、89.23%（P<0.01）;CT扫描检出肌瘤数目占比、显示肌瘤边界清晰数占比、检出肌瘤变性率分别为95.22%、92.28%、92.31%，均高于经阴道超声检查的81.99%、79.42%、57.69%（P<0.05）;CT扫描对不典型子宫肌瘤的诊断符合率为95.89%，高于经阴道超声检查的82.67%（P<0.05）;CT扫描误诊率为4.41%，低于经阴道超声检查的13.97%（P<0.05）。 结论 CT扫描对子宫肌瘤诊断符合率高于经阴道超声检查，对子宫肌瘤数目、边界、肌瘤变性显示优于经阴道超声检查。

[关键词] 经阴道超声;CT扫描;子宫肌瘤;肌壁间肌瘤;浆膜下肌瘤;黏膜下肌瘤

[Abstract] Objective To explore the application value of transvaginal ultrasound and CT scan in diagnosis of hysteromyoma. Methods The clinical data of 136 patients with hysteromyoma admitted to our hospital from June 2017 to June 2019 were analyzed. All the patients accepted transvaginal ultrasound and CT scan and the coincidence rate in diagnosing hysteromyoma， and the number， boundary， degeneration detection rate and misdiagnosis of myoma of the two methods were compared. Results The diagnostic coincidence rate of CT scan for intramural myoma was 100.00%， and the total diagnostic coincidence rate of hysteromyoma was 95.59%， both of which were higher than 86.30% and 89.23% of transvaginal ultrasound（P<0.01）. The percentage of the number，clear boundary and degeneration rate of myoma detected by CT scan were 95.22%， 92.28% and 92.31%， respectively， which were higher than 81.99%， 79.42% and 57.69% of those detected by transvaginal ultrasound（P<0.05）. The diagnostic coincidence rate of CT scan for atypical hysteromyoma was 95.89%， which was higher than 82.67% of transvaginal ultrasound（P<0.05）. The misdiagnosis rate of CT scan was 4.41%，lower than that of transvaginal ultrasound（13.97%）（P<0.05）. Conclusion The diagnostic coincidence rate of CT scan for hysteromyoma is higher than that of transvaginal ultrasound， and it is superior to transvaginal ultrasound in showing the number， boundary and degeneration of hysteromyoma.

[Key words] Transvaginal ultrasound; CT scan; Hysteromyoma; Intramural myoma; Subserous myoma; Submucosal myoma

子宮肌瘤是女性常见的生殖系统良性病变，30～50岁育龄妇女为好发人群，其发病率为5%～50%[1]。子宫肌瘤生长缓慢，不易发现，仅有部分患者出现月经紊乱、下腹疼痛、腹部扪及肿物等症状。早发现、早诊断是治疗子宫肌瘤和改善患者预后的关键。经阴道超声、CT扫描广泛应用于妇科盆腔疾病的诊断和治疗中。经阴道超声具有经济实惠、操作简单、检查快速、安全无损的优点，但对组织显示有一定的局限。CT扫描具有操作简单、检查快速、分辨率高等优势。既往关于子宫肌瘤的诊断中，研究重点为经阴道超声联合腹部超声、单纯CT检查、MRI检查的诊断效能，对经阴道超声和CT扫描比较分析的研究报道较少[2-4]。因此，本研究比较单纯采用经阴道超声和CT扫描在诊断子宫肌瘤中的价值，现报道如下。

1 资料与方法

1.1 一般资料

选取我院2017年6月至2019年6月收治的136例子宫肌瘤患者的临床资料进行分析。纳入标准：①经手术病理确诊;②临床资料完整;③均行经阴道超声检查、CT检查。……