Adenomyosis and uterine hypertrophy of the differential diagnosis in both clinical or ultrasound examination is more difficult, the paper confirmed by surgery and pathology of the 45 cases of adenomyosis and seven cases of a mast of a retrospective analysis, Discussion on the two main transvaginal ultrasound sonography and color Doppler flow imaging (CDFI) characteristics, particularly color Doppler energy (CDE) features aimed at improving both the diagnosis rates are now 52 cases of adenomyosis and uterine hypertrophy of the ultrasonographic features, color Doppler and energy characteristics of the report are as follows.
1 information and methods
1.1 in the general hospital maternity line hysterectomy and pathologically confirmed 45 cases of adenomyosis, aged 29 to 50 years old, an average of 39-year-old, seven cases of uterine hypertrophy, aged 32 to 51 years old, an average of 41 years. Simple adenomyosis 37 cases, adenomyosis merger of eight cases of uterine fibroids.
1.2 Methods LOGIQ700 of color Doppler ultrasound diagnostic apparatus, vaginal probe frequency of 7.0 MHz, color Doppler frequency of 5.0 MHz. Observation of two-dimensional images of uterine shape, contour, the muscle wall echo, endometrial line offset whether measured before and after the uterine size and wall thickness. Then CDFI, CDE observation of uterine muscle wall flow, and pulse Doppler detection, measurement peak systolic velocity (Vmax), end-diastolic velocity (Vmin) and resistance index (RI). Finally, the results of ultrasound examination and pathology results compared.
2 results
Adenomyosis audio and visual performance for the uniformity of the uterus or heterogeneity increased in the past for the increase after the trail. Echo uneven muscle wall, the increase was small and low-echo echo staggering 12 cases, the echo of inequality within the muscle wall that hypoechoic small Nangqiang, a honeycomb of 30 cases, the lesions into small pieces with no echo (about the size 1.5 ~ 2.1cm) 3 cases, merging eight cases of uterine fibroids. Adenomyosis good part is the back wall of the uterus, often from the back wall thickening obvious, and makes endometrial line Shaopian ago. CDFI show increased blood flow to the uterus, diseases muscle wall that point, strip red, blue blood flow. CDE performance for the uterine muscle wall rich blood flow, blood vessel thickening, with a diffuse congestion, lines pulse Doppler detection, measurement Vmax, Vmin and RI, the results for the high-speed high resistance artery spectrum, RI value of 0.79 ± 0.08, Flake in the dark vein to the region to record the spectrum.
Uterine hypertrophy of audio and visual performance of the uterus to increase regular shape, thickness uniformity of muscle to Qian Houbi thickening Obviously, the muscle wall or even a slightly lower or less uniform Shaoqiang echo, five cases of this group were slightly lower Echo, two cases were Shaoqiang echo. CDFI showed that blood flow within the uterine muscle wall no significant changes were scattered in point, spot-like red, blue-and blood flow. CDE showed diffuse distribution of macular, radial flow and distribution of a concentric weakening trend and are not easy to record vein spectrum, pulse Doppler test for high-speed medium-resistance index, RI value of 0.6 ± 0.06.
3 discussion
Adenomyosis and uterine hypertrophy of both the history and signs and two-dimensional image, have many similarities: the menstrual history of increased menstrual extension, dysmenorrhea, lumbosacral pain; signs of increased uterine; Two-dimensional image of the thickened muscle, echo inequality can be confused by the diagnosis. Transvaginal ultrasound CDFI and CDE to provide both the differential diagnosis of great help, especially the latter. Transvaginal color Doppler ultrasound examination of the uterus understanding of the Doppler signal than ideal for inspection by the abdomen, abdominal examination of the use of low-frequency probe to ensure that the necessary penetration, relatively poor resolution, image quality affected , Limited the accuracy of diagnosis. High frequency of vaginal probe (5 ~ 7.5 MHz), the probe near the pelvic organs and reduce the penetration of the requirements can receive high-resolution 2-D images and high sensitivity of the color flow signal, get more Information, help to improve diagnosis [1].
CDE than CDFI, CDE response to the campaign is the number of red blood cells, rather than show the direction of movement, CDE not rely on the Doppler angle from the impact of aliasing, also showed that a regional signal, can detect very slow RBC campaign, when the average velocity is zero time, CDE still can show blood flow in the region [1]. Therefore CDE CDFI with a high sensitivity to detect very low flow rate and the low level signals, CDE CDFI can not show a clear flow of small terminals show, and fully reflects the changes in blood flow, CDE of the flow of low-velocity sensitivity, to better show the vascular lesions in the trees and vascular network. At the same time in the form of vascular structure, CDE CDFI showed that the blood vessels more long, multi-branch, vascular tree relatively complete [2]. CDE compensate for the deficiencies of the CDFI, to provide more diagnostic information.
Adenomyosis lesions peripheral vascular see rough mess, blood vessel thickening shows, embracing, the wall smooth, clear [2]. Wall muscle lesions rich blood flow signals, with a diffuse congestion, the blood supply was high resistance characteristics of high-speed, easy to record the spectrum vein. Hypertrophy of the uterine muscle, blood vessels due to distribution and vascular resistance have no significant change [3], and it showed similar to the normal uterine blood flow signals showed diffuse distribution of macular, radial flow, the distribution of concentric weakened, not records Spectrum to the vein, the blood supply was high-speed characteristics of middle-resistance index.
Transvaginal ultrasound CDE more objective response to the disease of the uterine muscle wall flow situation, CDE showed that the blood flow more complete and rich, visual images, easier to understand, for adenomyosis and uterine hypertrophy of the differential diagnosis More information.
1 information and methods
1.1 in the general hospital maternity line hysterectomy and pathologically confirmed 45 cases of adenomyosis, aged 29 to 50 years old, an average of 39-year-old, seven cases of uterine hypertrophy, aged 32 to 51 years old, an average of 41 years. Simple adenomyosis 37 cases, adenomyosis merger of eight cases of uterine fibroids.
1.2 Methods LOGIQ700 of color Doppler ultrasound diagnostic apparatus, vaginal probe frequency of 7.0 MHz, color Doppler frequency of 5.0 MHz. Observation of two-dimensional images of uterine shape, contour, the muscle wall echo, endometrial line offset whether measured before and after the uterine size and wall thickness. Then CDFI, CDE observation of uterine muscle wall flow, and pulse Doppler detection, measurement peak systolic velocity (Vmax), end-diastolic velocity (Vmin) and resistance index (RI). Finally, the results of ultrasound examination and pathology results compared.
2 results
Adenomyosis audio and visual performance for the uniformity of the uterus or heterogeneity increased in the past for the increase after the trail. Echo uneven muscle wall, the increase was small and low-echo echo staggering 12 cases, the echo of inequality within the muscle wall that hypoechoic small Nangqiang, a honeycomb of 30 cases, the lesions into small pieces with no echo (about the size 1.5 ~ 2.1cm) 3 cases, merging eight cases of uterine fibroids. Adenomyosis good part is the back wall of the uterus, often from the back wall thickening obvious, and makes endometrial line Shaopian ago. CDFI show increased blood flow to the uterus, diseases muscle wall that point, strip red, blue blood flow. CDE performance for the uterine muscle wall rich blood flow, blood vessel thickening, with a diffuse congestion, lines pulse Doppler detection, measurement Vmax, Vmin and RI, the results for the high-speed high resistance artery spectrum, RI value of 0.79 ± 0.08, Flake in the dark vein to the region to record the spectrum.
Uterine hypertrophy of audio and visual performance of the uterus to increase regular shape, thickness uniformity of muscle to Qian Houbi thickening Obviously, the muscle wall or even a slightly lower or less uniform Shaoqiang echo, five cases of this group were slightly lower Echo, two cases were Shaoqiang echo. CDFI showed that blood flow within the uterine muscle wall no significant changes were scattered in point, spot-like red, blue-and blood flow. CDE showed diffuse distribution of macular, radial flow and distribution of a concentric weakening trend and are not easy to record vein spectrum, pulse Doppler test for high-speed medium-resistance index, RI value of 0.6 ± 0.06.
3 discussion
Adenomyosis and uterine hypertrophy of both the history and signs and two-dimensional image, have many similarities: the menstrual history of increased menstrual extension, dysmenorrhea, lumbosacral pain; signs of increased uterine; Two-dimensional image of the thickened muscle, echo inequality can be confused by the diagnosis. Transvaginal ultrasound CDFI and CDE to provide both the differential diagnosis of great help, especially the latter. Transvaginal color Doppler ultrasound examination of the uterus understanding of the Doppler signal than ideal for inspection by the abdomen, abdominal examination of the use of low-frequency probe to ensure that the necessary penetration, relatively poor resolution, image quality affected , Limited the accuracy of diagnosis. High frequency of vaginal probe (5 ~ 7.5 MHz), the probe near the pelvic organs and reduce the penetration of the requirements can receive high-resolution 2-D images and high sensitivity of the color flow signal, get more Information, help to improve diagnosis [1].
CDE than CDFI, CDE response to the campaign is the number of red blood cells, rather than show the direction of movement, CDE not rely on the Doppler angle from the impact of aliasing, also showed that a regional signal, can detect very slow RBC campaign, when the average velocity is zero time, CDE still can show blood flow in the region [1]. Therefore CDE CDFI with a high sensitivity to detect very low flow rate and the low level signals, CDE CDFI can not show a clear flow of small terminals show, and fully reflects the changes in blood flow, CDE of the flow of low-velocity sensitivity, to better show the vascular lesions in the trees and vascular network. At the same time in the form of vascular structure, CDE CDFI showed that the blood vessels more long, multi-branch, vascular tree relatively complete [2]. CDE compensate for the deficiencies of the CDFI, to provide more diagnostic information.
Adenomyosis lesions peripheral vascular see rough mess, blood vessel thickening shows, embracing, the wall smooth, clear [2]. Wall muscle lesions rich blood flow signals, with a diffuse congestion, the blood supply was high resistance characteristics of high-speed, easy to record the spectrum vein. Hypertrophy of the uterine muscle, blood vessels due to distribution and vascular resistance have no significant change [3], and it showed similar to the normal uterine blood flow signals showed diffuse distribution of macular, radial flow, the distribution of concentric weakened, not records Spectrum to the vein, the blood supply was high-speed characteristics of middle-resistance index.
Transvaginal ultrasound CDE more objective response to the disease of the uterine muscle wall flow situation, CDE showed that the blood flow more complete and rich, visual images, easier to understand, for adenomyosis and uterine hypertrophy of the differential diagnosis More information.
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