| Objective:Summarize the clinical parameters and ultrasound characteristics of uterine sarcoma and uterine fibroids,to analyze the differences between color Doppler ultrasound in uterine sarcoma and uterine fibroids,and explore the differential diagnosis value of Adler blood flow classification and combined ultrasound in two diseases.Method:A retrospective analysis of 154 patients diagnosed with uterine sarcoma and uterine fibroids after pathological examination at the First Hospital of Shanxi Medical University from October 2016 to December 2019.Divided into two groups according to the results of pathological examination,analyze the general situation and ultrasound characteristics of patients,compare the differences in ultrasound diagnosis between the two groups of diseases,and explore the diagnostic value of Adler blood flow classification in the two groups of diseases.SPSS 22.0 statistical analysis software package was used to process the data.After single factor analysis of its clinical and ultrasound characteristics,Logistic regression analysis was used,and its clinical diagnostic value was analyzed by receiver operating characteristic curve(ROC).Result:1.The age of uterine sarcoma is higher than that of uterine fibroids,and most of them have been menopausal.The difference between the two is statistically significant(P <0.05).The clinical manifestations of uterine sarcoma and uterine fibroids are similar.The differences between the two groups in terms of abdominal pain and rapid tumor growth are statistically significant(P <0.05),and there is nostatistically significant difference in vaginal bleeding(P> 0.05).The CA125 level in the uterine sarcoma group was higher than that in the uterine fibroids group,but there was no significant difference between the two(P> 0.05).2.In the two groups of patients,the median diameter of the largest diameter of uterine sarcoma was 12 cm,and the median diameter of the largest diameter of uterine fibroids was 8.5cm.Uterine sarcoma mainly manifests as a single cystic solid mass with unclear boundaries,while fibroids are mainly multiple solid cysts with clear boundaries,and the differences in the above ultrasonic characteristics are statistically significant(P <0.05).3.In uterine sarcoma cases,most of the tumors showed rich blood flow,18 cases(46.2%)had grade III blood flow,15(38.5%)cases had grade II blood flow,and 5cases(12.7%)had grade I blood flow,only 1 case(2.6%)had no blood flow;Uterine fibroid blood flow is relatively sparse,14 cases(12.2%)of grade no blood flow,65cases(56.5%)of grade I blood flow,35 cases(30.4%)of grade II blood flow,and only 1 case(0.9%)of blood flow Very rich,there is a statistical difference between the two(P <0.05).The RI of blood in the tumor was measured.The median RI value of the uterine sarcoma group was 0.39,which was significantly lower than the 0.59 of the uterine fibroids group,and the difference was statistically significant(P <0.05).4.Logistic multivariate analysis showed whether menopause(OR = 0.091),unclear boundaries(OR = 0.063),internal structure(OR = 0.044),blood flow classification(OR = 8.951),and RI(OR = 0)were risk factors for uterine sarcoma.Perform further ROC curve analysis on the above characteristics: Taking the blood flow grade I as the cutoff point,the sensitivity of diagnosis was 84.62% and the specificity was 68.7%.Taking RI = 0.46 as the cutoff value,the sensitivity of diagnosis is 72.36% and the specificity is 90.43%.Menopause(AUC = 0.742),unclear borders(AUC = 0.747),internal structure(AUC = 0.782),RI(AUC = 0.851),blood flow grading(AUC = 0.836)have a certain distinction between uterine sarcoma and uterine fibroid Diagnostic value,and the five combined examination(AUC =0.967)has a higher clinical diagnostic value,with a sensitivity of 87.18% and a specificity of 94.78%.Conclusion:1.Uterine fibroids and uterine sarcoma are significantly different in the age of first diagnosis,menopause,and clinical manifestations,so the above clinical indicators should be referred to when making ultrasound diagnosis.Serum CA125,as one of the auxiliary tests,is not very specific and sensitive.2.There are significant differences between uterine sarcoma and uterine fibroids in the number,internal echo,boundary definition,Adler blood flow grading,and RI,suggesting that they can be used as reference indicators for ultrasound diagnosis of both.3.Adler blood flow grading is performed on the blood flow signal in the tumor.The blood flow grading in uterine sarcoma is higher than that in uterine fibroids.The cutoff point of class I blood flow is used as the boundary to distinguish uterine sarcomas from uterine fibroids,which has better differential diagnosis value.4.Menopause,unclear borders,cystic internal structure,blood flow classification> Grade I and RI <0.46 are risk factors for uterine sarcoma,suggesting that the more the above manifestations,the more likely the lesion is uterine sarcoma.The combination of the five examinations can improve the differential diagnosis value of ultrasound before surgery. |
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