Value Of Combined Three-dimensional Ultrasound And Vascular Imaging In Diagnosing Intrauterine Benign And Malignant Lesions

ObjectiveTo evaluate and comparative the value of trans-vaginal two-dimensional ultrasound and trans-vaginal three-dimensional ultrasound in the diagnosis of intrauterine benign and malignant lesions. Comparison different of endometrial various lesions in endometrial thickness (ET), resistant index (RI), pulsatility index (PI) and endometrial volume (EV), provide guidance for clinical ultrasound diagnose.Methods171women diagnosed as intrauterine lesions by pathologic from October1,2012to October31,2013in Shanxi Grand hospital,58cases of endometrial hyperplasia,63cases of endometrial polyps,38cases of sub-mucosal uterine fibroids and12cases of endometrial carcinoma.1-3days before operation through2D-TVS and3D-TVS, to observe the ultrasonographic characteristics, measure relevant parameters and endometrial three-dimensional reconstruction and stored at the same time.Through Virtual Organ Computer Aided Analysis(VOCAL) software tracing endometrial outline to measurement and record endometrial volume.Through SPSS18.0statistical software, using Kappa to analyze the consistency test for2D-TVS、3D-TVS and pathological examination of intrauterine lesions. To evaluate ability of diagnosis intrauterine lesions of two inspection methods uses specificity and sensitivity. Use pared Chi-square test compare the differences of diagnose accordance rate between2D-TVS and3D-TVS. Parameters comparison between endometrial various lesions use ANOVA and LSD-t test whether there is a statistically significant between any two groups. Results1. There are good consistent for intrauterine by2D-TVS,3D-TVS and pathologic results.2. By2D-TVS to diagnose endometrial hyperplasia, endometrial polyps, sub-mucosal uterine fibroids and endometrial carcinoma, specificity and sensitivity respectively are85.0%、90.7%、91.0%、98.7%and84.5%、71.4%、86,8%、66.7%;3. By3D-TVS to diagnose endometrial hyperplasia, endometrial polyps, sub-mucosal uterine fibroids and endometrial carcinoma, specificity and sensitivity respectively are93.8%、96.3%、97.7%、98.7%and91.4%、87.3%、92.1%、83.3%;4. The diagnose accordance rate of the3D-TVS for intrauterine benign and malignant lesions is statistically higher than that of the2D-TVS (89.5%VS78.9%;p<0.05).5. Comparison endometrial thickness and endometrial volume between of endometrial various lesions groups in premenopausal women, in addition to, there is not statistically difference between endometrial hyperplasia group and endometrial carcinoma group (p=0.41/p=0.82), the rest of any two groups are statistically difference(p<0.05).6. Endometrial various lesions groups in postmenopausal women, endometrial thickness (16.21±3.96mm) and endometrial volume(18.22±3.97cm3) of endometrial carcinoma statistically higher than that of the rest of endometrial benign lesions (p<0.05).7. Endometrial malignant lesions average RI is0.45+0.05, statistically below than that of the endometrial benign lesions(p<0.05); Endometrial malignant lesions average PI is0.86±0.30, not statistically below than that of the endometrial benign lesions(p=0.15).Conclusions 1.2D-TVS and3D-TVS are good diagnostic tools to predict malignant and benign intrauterine lesions. The diagnose accordance rate of the3D-TVS is statistically higher than that of the2D-TVS. Provide a new thought of inspection to difficult diseases.2. The ET and EV are not good parameters for identify malignant and benign endometrial lesions in premenopausal women, just the opposite for postmenopausal women.3. The RI to malignant and benign endometrial lesions has important reference value. PI is not.