摘要目的:探讨经阴道超声弹性成像技术在子宫肌瘤和腺肌瘤鉴别诊断中的应用价值。方法:回顾性分析陆军第八十一集团军医院2017年1月至2019年2月期间收治经病理证实的54例子宫肌瘤、46例子宫腺肌瘤患者的临床病例资料及经阴道超声弹性成像影像学资料。比较实时超声弹性成像检查对子宫肌瘤、子宫腺肌瘤患者的诊断价值，及其弹性成像参数和影像学特点。结果:54例子宫肌瘤患者经过实时超声弹性成像检查确诊49例，诊断符合率为90.74%(49/54)；46例子宫腺肌瘤患者经过实时超声弹性成像检查确诊40例，诊断符合率为86.96%(40/46)；子宫肌瘤组的子宫动脉血流阻力指数低于子宫腺肌瘤组，正常肌层与病灶间的应变力比值(SR)高于子宫腺肌瘤组，组间差异具有统计学意义( P<0.05)；子宫肌瘤的实时超声弹性成像影像学特点为多具有规整的形状，圆形多见，边界较清楚，肌瘤内部主要显示为以蓝色为主的蓝绿相间的图像，周边有黄绿色或红色的包膜；子宫腺肌瘤的实时超声弹性成像影像学特点为形状不规整、边界不清，相对于正常肌壁的颜色更绿，甚至会出现黄红绿相间的图像。 结论:经阴道超声弹性成像技术在子宫肌瘤和腺肌瘤诊断鉴别诊断方面具有一定的临床价值。

abstractsObjective:To explore application value of transvaginal ultrasound elastography in differential diagnosis of uterine fibroids and adenomyoma.Methods:A retrospective analysis was performed on clinical case data and imaging data of transvaginal ultrasound elastography from 54 uterine fibroids patients and 46 adenomyoma patients confirmed by pathology who were admitted to the Hospital of PLA the 81 st Group Army from January 2017 to February 2019. To compare the diagnostic value, elastography parameters and imaging characteristics of real-time ultrasound elastography in patients with uterine leiomyoma and adenomyoma. Results:Among 54 patients with uterine fibroids, there were 49 cases confirmed by real-time ultrasound elastography, with diagnostic coincidence rate 90.74% (49/54). Among 46 patients with adenomyoma, there were 40 cases confirmed by real-time ultrasound elastography, with diagnostic coincidence rate 86.96% (40/46). The resistance index of uterine artery in uterine fibroid group was lower than that in adenomyoma group, while strain ratio (SR) between normal muscle layer and lesion was higher than that in adenomyoma group, with statistically significant difference ( P<0.05). The real-time ultrasound elastography of uterine fibroids was characterized by regular shape, common rounded shape, and clear boundary. The interior of fibroids was basically blue-green inter-image mainly on blue color. There was green-yellow or red capsule around. The real-time ultrasound elastography of uterine adenomyoma was characterized by irregular shape, unclear boundary, greener color than normal muscle wall, and even yellow-red-green inter-images. Conclusions:There is certain clinical value of transvaginal ultrasound elastography in differential diagnosis of uterine fibroids and adenomyoma.