关键词: 子宫腺肌瘤, 子宫肌瘤, 经阴道彩色多普勒超声, 诊断价值, 血流特点

Abstract:

Objective　To explore the clinical value of transvaginal color Doppler ultrasound (TVCD) in the diagnosis of uterine adenomyosis and uterine fibroids. Methods　A retrospective study was conducted on 102 patients with suspected uterine adenomyosis or uterine fibroids who visited Department of Gynecology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from March 2023 to March 2025. They were (42.35±6.72) years old. All the patients underwent TVCD examination, and their sonographic features and blood flow signal characteristics were recorded and compared with the surgical pathological results. t and χ² tests and Fisher's precision probability test were used for the statistical comparisons. The sensitivities, specificities, accuracies, positive predictive values, and negative predictive values of TVCD for diagnosing these two diseases were calculated. Results　Among the 102 patients, 45 had uterine adenomyosis, 51 had uterine fibroids, and 6 had both conditions, confirmed by surgical pathology. Six patients with both coexisting conditions were not included in the analyses of sensitivity, specificity, etc. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of TVCD for diagnosing uterine adenomyosis were 93.33% (42/45), 92.16% (47/51), 92.71% (89/96), 91.30% (42/46), and 94.00% (47/50), respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of TVCD for diagnosing uterine fibroids were 94.12% (48/51), 91.11% (41/45), 92.71% (89/96), 92.31% (48/52), and 93.18% (41/44), respectively. Uterine adenomyosis on TVCD mainly manifested as an enlarged uterus, heterogeneous myometrial echoes, cystic areas, and thickened posterior wall; uterine fibroids mainly presented as round hypoechoic or isoechoic masses with clear boundaries and posterior echo enhancement or attenuation. The blood flow of uterine adenomyosis showed a diffuse distribution, with a resistance index (RI) of 0.52±0.07; uterine fibroids showed predominantly peripheral blood flow, with an RI of 0.64±0.06; there was a statistical difference in RI between them (P<0.05). Conclusions　TVCD has high diagnostic value for uterine adenomyosis and uterine fibroids. Its characteristic manifestations and blood flow patterns provide important evidences for clinical differential diagnosis.

Key words: Uterine adenomyosis,  , Uterine fibroids,  , Transvaginal color Doppler ultrasound,  , Diagnostic value,  , Blood flow characteristics