Real-time Shear Wave Elastography Evaluation On Endometrial Hyperplasia

Objective:Investigate the diagnostic value of endometrial hyperplasia(EH)in patients with endometrial stiffness measured by real-time shear wave elastography.Methods:Collect the hospital pathology results for typical hyperplasia(typical EH,TEH),atypical hyperplasia(atypical EH,AEH)patients 30 cases,Thirty cases with normal proliferative phase(two-dimentional ultrasound showed that the endometrium had the three line sign)were selected as control group.First,the endometrium was examined by two-dimensional ultrasound to observe the situation of theendometrium.Switch to SWE mode(range: 0~180kPa)and place it on the endometrium for 3-5 s,and then freeze the image after stabilization.Quantitative analysis software was started to measure the suspicious part of endometrium(the thickest part of endometrium or the most non-uniform part of endometrium)for 3 times,including the average value,maximum value,minimum value and depth.The mean value of the average young’s modulus of each group was recorded and calculated.To be followed by hysteroscopy or postoperative pathological results.The ROC curve was drawn,and the optimal cut-off value of young’s modulus in diagnosing AEH was evaluated.Results:The average young’s modulus values of TEH group,AEH group and normal group were(14.28±5.30)kPa,(55.62±14.12)kPa and(25.37±8.52)kPa,respectively,with statistically significant differences(P<0.05).The AEH group was significantly higher than the normal group and TEH group.The mean young’s modulus in the normal group was higher than that in the TEH group,and the difference between the two groups was statistically significant(P<0.05).The area under the ROC curve of AEH group was 0.98[(p<0.05),95%CI(0.96,1.00)],the optimal cutoff value was 34.16 kPa,and the sensitivity and specificity were 100% and93.30%,respectively.Conclusion:The results showed that the endometrial hardness of AEH was higher than that of TEH and the normal group,and the endometrial hardness of the normal group was higher than that of TEH group,indicating that SWE can quantitatively diagnose EH,which makes another step forward for the diagnosis of gynecological diseases by ultrasound elastography.