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| Differentiation of uterine submucosal fibroids from atypical polypoid adenomyomas based on clinical features and ultrasound imaging |
| #br# HU Yinnan, ZHU Ru, GUO ping |
| (Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing Anhui 246000, China) |
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Abstract Objective： To investigate the clinical features and the value of transvaginal color Doppler ultrasonography in differentiating uterine submucous myoma from atypical polypoid adenomyoma. Methods： Forty-five patients with uterine submucous myoma and 45 patients with atypical polypoid adenomyoma were selected from the Department of Obstetrics and Gynecology of Anqing Municipal Hospital from August 2019 to August 2022. Clinicopathological parameters of the two group patients
were collected, and the ultrasonic morphological characteristics and hemodynamic indexes of the patients were detected by Hitachi Ascendus color ultrasonic diagnostic instrument. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of hemodynamic indexes in the two groups. Results： Compared with atypical polypoid adenomyoma group, the incidence of anemia and dysmenorrhea in submucous myoma group was significantly increased, and intrauterine occupation was greatly decreased (P<0.05). The κ values of transvaginal color Doppler ultrasonography for submucosal fibroids and atypical polypoid adenomyomas were 0.762 (P<0.05) and 0.433 (P<0.05), respectively. Ultrasound imaging results showed that compared with atypical polypoid adenomyoma group, the proportions of low echo, uniform echo, regular shape and clear boundary in submucosal fibroids group were significantly increased (P<0.05), blood flow grade Ⅱ-Ⅲ in submucosal fibroids group was markedly increased (P<0.05), and blood flow resistance index was significantly decreased (P<0.05). ROC curve showed that the AUC of blood flow grade and blood flow resistance index for predicting atypical polypoid adenomyoma was 0.852 (95%CI: 0.765-0.921, P<0.001) and 0.861 (95%CI: 0.776-0.932, P<0.001), respectively. Conclusion： Compared with patients with atypical polypoid adenomyoma, patients with uterine submucous myoma had significant differences in clinical symptoms such as anemia, dysmenorrhea, intrauterine occupation and imaging characterization of transvaginal color Doppler ultrasonography. Patients with uterine submucous myoma and atypical polypoid adenomyoma could be distinguished by both clinical symptoms and transvaginal color Doppler ultrasonography.
［Key words］uterus myoma; endometrial atypical polypoid adenomyoma; clinical features; ultrasonic imaging
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Received: 10 January 2023
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| [1] |
. [J]. Journal of Jiangsu University(Medicine Edition), 2023, 33(04): 348-351. |
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