|
|
|
| Clinical differentiation of uterine myoma and adenomyosis by abdominal color doppler ultrasonography combined with diffusion-weighted imaging |
| Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine，Wenzhou, Zhejiang Province, 325000 |
|
|
|
|
Abstract To analyze the clinical differential value of abdominal color doppler ultrasound combined with diffusion-weighted imaging for diagnosing uterine myoma and adenomyosis. Methods: A total of 140 patients suspected of having uterine fibroids and adenomyosis from January 2018 to June 2021 were included in this study. All of these patients were subjected to abdominal color Doppler ultrasound and diffusion-weighted imaging before surgery. Taking postoperative pathological examination as the gold standard, the imaging characteristics of ultrasound and diffusion-weighted imaging were analyzed. The differential diagnostic efficacy for uterine myoma and adenomyosis was compared between abdominal color doppler ultrasound and diffusion-weighted imaging. Results: In 140 patients, there were 78 cases of uterine fibroids and 62 cases of adenomyosis were confirmed by pathological examination. There were 67 patients with uterine fibroids detected by abdominal color Doppler ultrasound, with the diagnostic coincidence rate of 85.9%, and there were 47 patients with adenomyosis, with the diagnostic coincidence rate of 75.8%. There were 71 cases of uterine fibroids detected by diffusion weighted imaging, with the diagnostic coincidence rate of 91.0%, and there were 55 patients with adenomyosis, with the diagnostic coincidence rate of 88.7%. There was no significant difference in the diagnostic coincidence rate between the abdominal color Doppler ultrasound and diffusion weighted imaging (P＞0.05). The values of the uterine artery pulsatile index (PI) and resistance index (RI) of the patients with uterine fibroids were significantly lower than those of the patients with adenomyosis. The rate of clear mass boundary of (65.4%) of the patients with uterine fibroids was significantly higher than that (29.0%) of the patients with adenomyosis (all P＜0.05). There was no significant difference in the ratio of T1WI, T2WI and DWI signal intensity of the diffusion-weighted imaging between the patients with uterine fibroids and the patients with adenomyosis (P＞0.05). The rate of regular mass boundary of uterine fibroids was significantly higher than that of adenomyosis, and the rate of blurred mass boundary of adenomyosis was significantly higher than that of uterine fibroids (P＜0.05). The ADC values in uterine fibroids and adenomyosis were significantly lower than those in normal myometrium tissue, and which in uterine fibroids was significantly higher than that in adenomyosis (P＜0.05). Receiver operating characteristic curve showed that the AUC of abdominal color Doppler ultrasound and diffusion-weighted imaging for differentiating uterine fibroids from adenomyosis were 0.801 and 0.846, with the sensitivity of 79.4% and 85.2%, and the specificity of 85.1% and 88.1%. The ACU, the sensitivity, and the specificity of abdominal color Doppler ultrasound and diffusion-weighted imaging for differentiating uterine fibroids from adenomyosis were 0.954, 99.2%, and 98.4%, respectively. Conclusion: Abdominal color Doppler ultrasound combined with diffusion-weighted imaging has great value for differential diagnosing uterine myoma from adenomyosis.
|
|
|
|
|
|
|
|
|
