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目的 探讨经阴道彩色多普勒超声 (TVS- CD)对妇科恶性肿瘤术后复发病灶的诊断价值。方法 对 6 0例妇科恶性肿瘤术后复发的患者行 TVS- CD检查 ,并与病理结果及临床对照。结果 经阴道超声 (TVS)检查 86 .7%的复发灶为实性肿块 ,少数为混合性 (8.3 %)或囊性 (5 .0 %)。彩色多普勒能量图(CDE)显示实性及混合性病灶以 II- III级血流信号为主 (86 .7%) ,少数为 0 - I级血流信号 (8.3 %) ,囊性病灶 (5 .0 %)未检出血流信号。频谱多普勒 (SD)测量血流阻力指数 (RI)平均值为 0 .6 0 ,搏动指数 (PI)平均值 1.2 6。 TVS- CD诊断术后复发符合率为 86 .7%,误诊 13 .3 %。结论 妇科恶性肿瘤术后复发灶的二维图像以实性低回声为主 ,病灶内血流多较丰富 ,与妇科原发肿瘤相比 ,复发灶血流阻力较高、速度较低 ,具有独特的声像图和血流动力学特征。 TVS- CD将 TVS与 CDE和 SD结合 ,可以检出较小的盆腔复发病灶 ,更准确地显示病灶内部结构和血流形态学、动力学表现 ,对妇科恶性肿瘤术后复发灶的早期发现和定性诊断具有重要价值 ,可作为临床随访观察的重要手段
Objective To investigate the value of transvaginal color Doppler ultrasound (TVS-CD) in the diagnosis of postoperative recurrence of gynecologic malignancies. Methods Sixty patients with recurrent gynecologic malignancies underwent TVS-CD and were compared with the pathological findings and clinical controls. Results Transvaginal ultrasonography (TVS) showed that 86.7% of the recurrent tumors were solid masses, with a few of them being mixed (8.3%) or cystic (5.0%). The color Doppler energy maps (CDE) showed that the grade II-III blood flow signals were predominant (86.7%) in real and mixed lesions, the few were grade 0-I blood flow signals (8.3%), cystic lesions (5.0%) did not detect the blood flow signal. Spectrum Doppler (SD) measurement of blood flow resistance index (RI) average of 0.6, pulsatility index (PI) of 1.2 6. TVS-CD diagnosis of postoperative recurrence coincidence rate of 86.7%, misdiagnosed 13.3%. Conclusion The postoperative recurrence of gynecological malignant tumors with two-dimensional images of solid hypoechoic mainly in the lesion more abundant blood flow, compared with the primary gynecologic tumor, the recurrence of the blood flow resistance is higher, lower speed, with a unique Sonography and hemodynamic characteristics. TVS-CD combines TVS with CDE and SD to detect smaller pelvic recurrence lesions, to more accurately display the internal structure of the lesion and blood flow morphology, kinetic performance, early detection of postoperative recurrence of gynecological malignancies and Qualitative diagnosis of great value, as an important means of clinical follow-up observation