子宫动脉血流动力学指标联合弹性成像评分在诊断子宫肌瘤变性中的价值

doi:10.3969/j.issn.1006-5725.2026.01.004

Abstract

Abstract:

Objective Exploring the Clinical Application Value of Uterine Artery Hemodynamic Parameters and Elastography Scores in Uterine Fibroid Degeneration. Methods A total of 158 patients with uterine fibroids， diagnosed by pathology and treated at our hospital from June 2022 to June 2024， were selected as the study group. Additionally， 150 healthy women who underwent routine health check-ups during the same period were selected as the control group. The study group was further divided into degeneration and non-degeneration subgroups based on the presence or absence of degeneration. Ultrasound was used to observe the location， size， and hemodynamic changes in the uterine arteries of the fibroid patients， and strain elastography was used to assess the elasticity of the lesions. Comparison of various parameters between the two groups was conducted， and receiver operating characteristic （ROC） curves were drawn to evaluate the diagnostic value of uterine artery hemodynamic parameters and elastography scores in the diagnosis of fibroid degeneration. Results There were statistically significant differences （P < 0.05） in the uterine artery hemodynamic parameters （RI， PI， V_min， EDV， PSV） and elastography scores between the study group and the control group. Among the study group， the PI， V_min， PSV， and elastography scores of the degeneration group were significantly different from those of the non-degeneration group （P < 0.05）. The PI， Vmin， PSV， and elastography scores were identified as diagnostic indicators for uterine fibroid degeneration （P < 0.05）. Using PI， V_min， PSV， and elastography scores as test variables and the degeneration and non-degeneration groups as reference standards， ROC curves were drawn. The AUC values for PI， V_min， PSV， and elastography scores were 0.714， 0.690， 0.660， and 0.669， respectively. The AUC for combined diagnosis of these indicators was 0.832. Conclusion Uterine artery hemodynamic parameters （PI， V_min PSV） and elastography scores have high diagnostic value for uterine fibroid degeneration， with the combined diagnostic value being even higher.

Key words: uterine fibroids, fibroid degeneration, arterial hemodynamic parameters, strain elastography, elastography scores

CLC Number:

R445.1

Meixia YIN,Jie TANG,Jing ZHAO,Bin YANG. Clinical application value of combined detection of uterine artery hemodynamic parameters and elastography score in uterine fibroid degeneration[J]. The Journal of Practical Medicine, 2026, 42(1): 29-36.

Figures/Tables 9

Fig.1

Tab.1

Tab.2

Fig.2

Tab.3

Tab.4

Tab.5

Tab.6

Fig.3

References 26

[1]	汪海金，王克功，龚廷，等. 腹腔镜引导下双侧子宫骶韧带区域神经阻滞在妇科腔镜子宫肌瘤剔除手术中的应用［J］. 实用医学杂志，2023，39（9）：1127-1131.doi：10.3969/j.issn.1006-5725.2023.09.011 . doi: 10.3969/j.issn.1006-5725.2023.09.011
[2]	韦玮，方梓羽，马艳群，等. 经皮神经电刺激联合加速康复外科多模式镇痛在腹腔镜全子宫切除术后的镇痛效果［J］. 实用医学杂志，2022，38（10）：1251-1254.doi：10.3969/j.issn.1006-5725.2022.10.015 . doi: 10.3969/j.issn.1006-5725.2022.10.015
[3]	周蓉. 子宫肌瘤对生育力的影响及其围手术期保护［J］. 实用妇产科杂志， 2024， 40（2）：84-87.
[4]	SOTOMAYOR C G， PARRA C， MIRANDA M， et al. Hyaline and Cystic Degeneration of Uterine Leiomyomas： CT and MR Imaging with Histopathological Sample Analyses［J］. Diagnostics （Basel），2023，13（20）：3230.doi： 10.3390/diagnostics13203230 . doi: 10.3390/diagnostics13203230
[5]	DUNPHY L， GEE M， FORD J. Red degeneration of fibroid presenting with abdominal pain in pregnancy［J］. BMJ Case Rep， 2025，18（8）：e263747. doi： 10.1136/bcr-2024-263747 . doi: 10.1136/bcr-2024-263747
[6]	JIANG S， XU Z， SHAO X， et al. Diagnostic value and clinical significance of serum miR-134-5p combined with uterine artery color Doppler ultrasound parameters in endometriosis［J］. BMC Womens Health， 2024，24（1）：544.doi： 10.1186/s12905-024-03372-w . doi: 10.1186/s12905-024-03372-w
[7]	WU J， LI Y， ZHANG X， et al. Assessment of blood flow around the knee joint in patients with knee osteoarthritis by color Doppler ultrasound［J］. Eur J Radiol， 2023， 166：111005.doi： 10.1016/j.ejrad.2023.111005 . doi: 10.1016/j.ejrad.2023.111005
[8]	HARAKE J EL， SAYSENG V， GRONDIN J， et al. Preliminary Feasibility of Stress Myocardial Elastography for the Detection of Coronary Artery Disease［J］. Ultrasound Med Biol， 2023，49（2）：549-559.doi： 10.1016/j.ultrasmedbio.2022.10.007 . doi: 10.1016/j.ultrasmedbio.2022.10.007
[9]	JIA W， LUO T， DONG Y， et al. Breast Elasticity Imaging Techniques： Comparison of Strain Elastography and Shear-Wave Elastography in the Same Population［J］. Ultrasound Med Biol， 2021，47（1）：104-113. doi： 10.1016/j.ultrasmedbio.2020.09.022 . doi: 10.1016/j.ultrasmedbio.2020.09.022
[10]	MILLER B S， SINGH S S， FLAXMAN T E. The effect of uterine fibroid region and depth on endometrial stress and strain： a finite element approach［J］. Comput Methods Biomech Biomed Engin， 2024，6：1-10. doi： 10.1080/10255842.2024.2431653 . doi: 10.1080/10255842.2024.2431653
[11]	孔北华，马丁，段涛. 妇产科学［M］. 10版.北京：人民卫生出版社，2024：316-320.
[12]	田士峰，刘爱连，牛淼，等. 扩散峰度成像定量参数直方图分析鉴别子宫癌肉瘤与变性子宫肌瘤的价值［J］. 中国临床医学影像杂志，2020，31（4）：281-284. doi：10.12117/jccmi. 2020. 04.012 . doi: 10.12117/jccmi. 2020. 04.012
[13]	蒋晓敏，纪瑞云，周宇佳.影响子宫肌瘤剔除术后妊娠及其结局的因素［J］.实用医学杂志，2020，36（24）：3385-3389.doi：10.3969/j.issn.1006-5725.2020.24.016 . doi: 10.3969/j.issn.1006-5725.2020.24.016
[14]	VANNUCCINI S， PETRAGLIA F， CARMONA F， et al. The modern management of uterine fibroids-related abnormal uterine bleeding［J］. Fertil Steril， 2024，122（1）：20-30.doi：10.1016/j.fertnstert.2024.04.041 . doi: 10.1016/j.fertnstert.2024.04.041
[15]	DOLMANS M M， PETRAGLIA F， CATHERINO W H， et al. Pathogenesis of uterine fibroids： Current understanding and future directions［J］. Fertil Steril， 2024，122（1）：6-11.doi： 10.1016/j.fertnstert.2024.02.048 . doi: 10.1016/j.fertnstert.2024.02.048
[16]	杨红玉，孙莉，杨波，等. 18～25岁子宫肌瘤临床及病理特征分析［J］. 临床误诊误治，2020，33（8）：80-84. doi：10.3969/j.issn.1002-3429 . doi: 10.3969/j.issn.1002-3429
[17]	张小敬，方群，刘赵一，等. 彩色多普勒成像联合子宫动脉血流参数诊断子宫肌瘤效果［J］. 中国计划生育学杂志， 2024， 32（3）：643-646. doi：10.3969/j.issn.1004-8189.2024.03.033 . doi: 10.3969/j.issn.1004-8189.2024.03.033
[18]	PIEROH P， LI ZL， KAWATA S，et al. The arterial blood supply of the symphysis pubis-Spatial orientated and highly variable［J］. Ann Anat， 2021，234：151649. doi： 10.1016/j.aanat.2020.151649 . doi: 10.1016/j.aanat.2020.151649
[19]	张逸群，张春莲，薛璐. 不同磁共振T2WI信号对子宫肌瘤患者术前超声造影血流灌注的评估价值［J］. 中国计划生育学杂志，2020，28（8）：1274-1277. doi：10.3969/j.issn.1004-8189.2020.08.031 . doi: 10.3969/j.issn.1004-8189.2020.08.031
[20]	PENG J， WANG J， SHU Q， et al. Systematic review and meta-analysis of current evidence in uterine artery embolization vs myomectomy for symptomatic uterine fibroids［J］.Sci Rep， 2024，14（1）：19252.doi：10.1038/s41598-024-69754-0 . doi: 10.1038/s41598-024-69754-0
[21]	SOTOMAYOR C G， PARRA C， MIRANDA M， et al. Hyaline and Cystic Degeneration of Uterine Leiomyomas： CT and MR Imaging with Histopathological Sample Analyses［J］. Diagnostics （Basel）， 2023，13（20）：3230.doi： 10.3390/diagnostics13203230 . doi: 10.3390/diagnostics13203230
[22]	TAKEUCHI M， MATSUZAKI K， BANDO Y， et al. Evaluation of red degeneration of uterine leiomyoma with susceptibility-weighted MR imaging［J］. Mag Resonance Med Sci，2019，18（2）：158-162.doi： 10.2463/mrms.mp.2018-0074 . doi: 10.2463/mrms.mp.2018-0074
[23]	WEN S， PENG B， WEI X，et al. Convolutional Neural Network-Based Speckle Tracking for Ultrasound Strain Elastography： An Unsupervised Learning Approach［J］. IEEE Trans Ultrason Ferroelectr Freq Control， 2023，70（5）：354-367. doi：10.1109/TUFFC.2023.3243539 . doi: 10.1109/TUFFC.2023.3243539
[24]	THOMSEN C R， JENSEN M S S， BOR P， et al. Recommendations for strain elastography of the uterine cervix［J］.Arch Gynecol Obstet， 2024，310（4）：2023-2033. doi： 10.1007/s00404-024-07693-x . doi: 10.1007/s00404-024-07693-x
[25]	张菁菁，徐海飞，李统怀，等. 声辐射力脉冲成像联合应力式弹性成像诊断子宫肌瘤变性的应用价值［J］. 临床超声医学杂志，2020，22（11）：843-846. doi： 10.3969/j.issn.1008-6978.2020.11.013 . doi: 10.3969/j.issn.1008-6978.2020.11.013
[26]	YAMASHITA Y， YAMAZAKI H， SHIMOKAWA T， et al. Shear-wave versus strain elastography in endoscopic ultrasound for the diagnosis of chronic pancreatitis［J］. Pancreatol， 2023，23（1）：35-41.doi：10.1016/j.pan.2022.11.009 . doi: 10.1016/j.pan.2022.11.009

组别	RI	PI	V_min/（cm/s）	EDV/（cm/s）	PSV/（cm/s）	弹性成像评分/分
研究组（n = 158）	0.65 ± 0.12	1.58 ± 0.26	15.46 ± 2.84	8.79 ± 2.17	42.56 ± 4.26	4.08 ± 0.62
健康对照组（n = 150）	0.94 ± 0.21	2.13 ± 0.30	18.86 ± 3.43	13.63 ± 2.08	47.84 ± 5.16	1.19 ± 0.28
t值	14.974	17.219	9.495	19.964	9.813	52.251
P值	0.000	0.000	0.000	0.000	0.000	0.000

临床资料	非变性组（n = 127 ）	变性组（n = 31）	t值	P值
年龄/岁	36.12 ± 10.24	35.32 ± 10.17	0.390	0.697
BMI/（kg/m²）	22.68 ± 1.42	23.16 ± 1.33	1.708	0.090
产次/次	1.26 ± 0.35	1.35 ± 0.28	1.330	0.185
RI	0.61 ± 0.13	0.65 ± 0.12	1.637	0.104
PI	1.45 ± 0.18	1.62 ± 0.26	3.441	0.001
V_min/（cm/s）	15.71 ± 2.33	14.13 ± 2.15	3.434	0.001
EDV/（cm/s）	9.11 ± 2.44	8.36 ± 2.12	1.572	0.118
PSV/（cm/s）	43.41 ± 4.74	41.25 ± 4.15	2.328	0.021
弹性成像评分/分	4.39 ± 0.50	3.98 ± 0.60	3.516	0.001

类型	例数	弹性成像评分/分
玻璃样变性	15	4.73 ± 0.46
部分囊性病变	10	2.20 ± 0.42
脂肪变性	5	2.80 ± 0.45
肉瘤样变性	1	4

因素	变量	赋值
子宫肌瘤变性	Y	原值代入
PI	X1	原值代入
V_min	X2	原值代入
PSV	X3	原值代入
弹性成像评分	X4	玻璃样变性= 1；部分囊性病变= 2；脂肪变性= 3；肉瘤样变性= 4

自变量	回归系数	S.E.	Wald值	P值	OR	95% CI
X1:PI	4.043	1.187	11.608	0.001	57.009	5.569 ~ 583.570
X2:V_min	-0.293	0.108	7.411	0.006	0.746	0.604 ~ 0.921
X3:PSV	-0.135	0.01	4.926	0.026	0.873	0.775 ~ 0.984
X4:弹性成像评分	1.196	0.425	7.911	0.005	3.308	1.437 ~ 7.612
常数	-2.580	4.021	0.412	0.521	0.076

Clinical application value of combined detection of uterine artery hemodynamic parameters and elastography score in uterine fibroid degeneration

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 9

References 26

Related Articles 15

Recommended Articles

Metrics

Comments

检测变量	AUC	标准误	临界值	灵敏度/%	特异度/%	95%CI
PI	0.714	0.0603	1.53	71.00	72.40	0.637 ~ 0.783
V_min	0.690	0.0511	15.25 cm/s	70.97	64.57	0.611 ~ 0.761
PSV	0.660	0.0425	43.35 cm/s	90.32	52.76	0.581 ~ 0.734
弹性成像评分	0.669	0.0419	4	38.71	84.25	0.590 ~ 0.742
联合预测	0.832	0.0381	0.17	87.10	72.44	0.764 ~ 0.887

[1]	Tianyuan LI,Ying TIAN,Dingde LONG,Yang DONG,Huan. FU. An interpretable machine learning model based on bedside lung and diaphragm ultrasound for preoperative prediction of pulmonary dysfunction in gastrointestinal tumor surgery： A clinical study [J]. The Journal of Practical Medicine, 2025, 41(24): 3929-3940.
[2]	Xinran ZHANG,Yan SHEN,Jiaojiao HU,Qingqing CHEN,Yangjie XIAO,Feng LU,Shasha YUAN,Xiaohong FU. Study on the applied value of combined clinical and ultrasound multiparameter constructed nomogram for predicting HER⁃2⁃positive breast cancer [J]. The Journal of Practical Medicine, 2025, 41(18): 2812-2819.
[3]	Zelin XU,Zhenhao ZHENG,Yaqian DENG,Guanming ZENG,Tingting DU,Peishan ZHU,Wen LIU,Jun. LI. Predictive value of dual‑modality ultrasound combined with S‑Detect for cervical lymph node metastasis in papillary thyroid carcinoma [J]. The Journal of Practical Medicine, 2025, 41(16): 2581-2589.
[4]	Xinyu JIAO,Ying GUO,Hongpeng LIU,Pengyu ZHU,Yu CAO,Wei CHEN,Hong HUO,Dan. XIE. Diagnostic value of high frequency ultrasonography in acute phase of peripheral facial paralysis [J]. The Journal of Practical Medicine, 2025, 41(14): 2258-2263.
[5]	Shangpeng HE,Weixian HUANG,Yanhui JIANG,Xiongqiang PENG,Lingcui MENG,Jianxing ZHANG. Value of ultrasound radiomics in re⁃evaluating the benign or malignant of Bethesda Ⅲ nodules [J]. The Journal of Practical Medicine, 2025, 41(12): 1892-1898.
[6]	Erfang GUO,Lei FENG,Chaohui SHI,Ning LI,Weiqun LIN,Shuhua. ZHANG. Construction and evaluation of a diagnostic model for female stress urinary incontinence based on the morphology and elasticity of the levator ani muscle by transperineal three⁃dimensional ultrasound combined with shear wave elastography [J]. The Journal of Practical Medicine, 2025, 41(8): 1224-1231.
[7]	Jiaqi SHEN,Yu KANG,Xuhong NAN,Xiaoxi. SHA. The application value of color doppler ultrasound combined with real⁃time shear wave elastography in the diagnosis of vascular erectile dysfunction [J]. The Journal of Practical Medicine, 2025, 41(6): 877-881.
[8]	Ying ZOU,Jihua LIU,Jingyi LI,Hai BI,Yan SHI,Xiudi LU,Qibo. ZHANG. Efficacy of transfer learning artificial intelligence model based on ultrasound in evaluating the probability of malignancy of partially cystic thyroid nodule [J]. The Journal of Practical Medicine, 2025, 41(6): 889-895.
[9]	Danhui LAI,Yanhui JIANG,Siting YE,Shulian ZHUANG,Shuang YANG,Wen XUE,Jianxing ZHANG. Analysis of prediction of carotid in-stent restenosis based on ultrasonographic carotid plaque radiomics [J]. The Journal of Practical Medicine, 2025, 41(5): 742-750.
[10]	Yue LV,Yanna MENG,Panpan LI,Yinghong. CHEN. Value of SWD in preoperative assessment of liver fibrosis in patients with hepatocellular carcinoma [J]. The Journal of Practical Medicine, 2025, 41(5): 751-755.
[11]	Changhui WU,Zhiping HUANG,Huiping DAI,Huifang QIU,Chun HE,Fang. TANG. Energy efficiency of contrast⁃enhanced ultrasound combined with TERT promoter mutation to construct a nomogram model for the prediction of concomitant cervical lymph node metastasis in PTMC [J]. The Journal of Practical Medicine, 2025, 41(5): 756-765.
[12]	Yan LI,Ziran JIN,Haotian SUN,Xuan LIU,Jing. GAO. Assessment of left ventricular systolic function in type 2 diabetes patients with renal insufficiency by aCMQ technique [J]. The Journal of Practical Medicine, 2025, 41(3): 414-421.
[13]	Kui XU,Jun. ZHOU. Research progress of ultrasound microbubbles in diagnosis and treatment of thyroid cancer [J]. The Journal of Practical Medicine, 2025, 41(3): 454-458.
[14]	Boyang YANG,Qian FANG,Yi ZHENG,Hongying. WANG. Quantitative diagnosis of annular pancreas in neonates with saline⁃contrast ultrasound [J]. The Journal of Practical Medicine, 2024, 40(18): 2618-2622.
[15]	Wei ZHANG,Xiyang HU,Yunna ZHANG,Lingling SHEN,Minhui LI,Shasha SONG,Jian. ZHANG. The combination of dual⁃energy CT and musculoskeletal ultrasonography has shown promise in distinguishing between calcium pyrophosphate deposition disease and gouty arthritis [J]. The Journal of Practical Medicine, 2024, 40(17): 2477-2482.