The Value Of Ultrasound In The Diagnosis Of Uterine Sarcoma And Leiomyomas

Objective:To evaluate the contribution of ultrasonography(US)in the differentialdiagnosis of uterine leiomyomas and sarcomas.Methods:Retrospectively analyzed the US features of 70 leiomyomas and 20 uterine sarcomashospitalized in Qilu hospital from 2013 to 2016, compared the number, size, location, morphology, margin and the echopatterns of the benign and malignant lesions, together with their CDFI distinctions.Results:20 cases of patients with uterine sarcoma pathological type:11 cases of uterine leiomyosarcoma (LMS).1 case of angiosarcoma, rhabdomyosarcoma in 1 cases, undifferentiated endometrial sarcomas in 1 case,4 cases of uterine mullerian adenosarcoma, carcinosarcoma in 2 cases。。The average age of uterine sarcoma is (49.5±9.2), and the leiomyomas is (43.1±7.9)。 The patientswith leiomyomas were significantly younger than those with sarcomas(P<0.05). The occurrence ofvaginal bleeding, Especially in postmenopausal bleeding and vaginal lesion and vaginal lesion was statistically higher among sarcomas than in leiomyomas(P<0.05). Sonographic features like the tumor size, shape and echo texture were well associated with macroscopicconfiguration. The average diameter of uterine sarcoma is (7.5±4.0) cm, while the leiomyomas is (6.7±2.4) cm, The size of sarcomas was approximate to leiomyomas(P>0.05). Uterine sarcomas wereidentified as large, solitary, irregular, ill—defined, honeycomb pattern with moderate/mixed echo. leiomyomas wereidentified as multiple, regular, solid pattern with low echo。Gray scale US characteristics between and sarcomas showed statisticalsignificance(P<0.05).Rich peripheral and internal vascularity with an irregular shape was thecharacteristic color flow imaging pattern of uterine sarcoma. Uterine leiomyomas was featured with regularhypovascularity (P<0.05).Conclusions (1) uterine sarcoma and uterine fibroids in the age of onset, age distribution, clinical manifestations and other aspects of a significant difference, they can be used as an auxiliary standard in ultrasound diagnosis.(2) Uterine sarcoma and leiomyomas have significant differences in number, the diseased parts, echo type, internal structure, etc. in this study, uterine sarcoma is often solitary in the muscle layer or uterine cavity, as a solid lesions with moderate/mixed echo。it can be used as the reference standard of ultrasound diagnosis.(3)there are significant differences in blood flow distribution and abundance of uterine sarcoma and leiomyomas, uterine sarcoma is the pathological changes of abundant peripheral and internal blood flow.(4)Color Doppler ultrasound can accurately determine the tumor boundary and judge the occurrence of muscle invasive, and explorate the blood flow signal。 It has a good supporting role on the identification of malignant uterine sarcomas and benign leiomyomas。However, different histological types of uterine sarcoma have different ultrasonic characteristics, some characteristics (such as RI)are similarto leiomyomas, diagnosisof uterine sarcoma subtypeis difficult to achieve, the individual types of uterine sarcoma (especially LMS) and leiomyomas preoperative difficult to identify.