微血流成像与彩色多普勒对子宫内膜良恶性病变的鉴别价值
本研究为回顾性病例对照研究，纳入132例子宫内膜病变患者，以术后病理为金标准，比较MV-Flow定量参数VIMV与CDFI的诊断效能。结果显示MV-Flow对良性及恶性病变总体血流检出率均高于CDFI，恶性组以多发血管为主，VIMV AUC最高。
要点
- MV-Flow对恶性病变血流检出率100%，显示微血管更清晰。
- VIMV阈值≥15.6时，诊断敏感度79.55%，特异度77.27%。
- 恶性组血管模式以多发血管为主，与良性组差异显著（P<.001）。
核心结论
- MV-Flow显示子宫内膜病变微血管优于CDFI，可提供更丰富血流信息。
- 定量参数VIMV对良恶性子宫内膜病变具有较高诊断价值。
- VIMV与MV-Flow诊断效能均显著高于CDFI（P分别为.015和.026）。
研究设计与样本
- 回顾性病例对照研究，共纳入132例子宫内膜病变患者。
- 术前采用CDFI与MV-Flow评估血流显示并计算VIMV，以术后组织病理结果为金标准。
- 通过ROC曲线分析评估并比较VIMV、MV-Flow与CDFI的诊断效能。
关键影像表现/征象
- MV-Flow对良性及恶性病变总体血流检出率为88.63%，恶性病变为100%，均高于CDFI的73.48%和86.36%。
- MV-Flow显示微血管更清晰；恶性组以多发血管为主，包括局灶性起源与多灶性起源。
诊断标准与关键数值
- VIMV、MV-Flow与CDFI鉴别良恶性病变的AUC分别为0.872、0.846和0.786。
- VIMV阈值取≥15.6时，诊断敏感度为79.55%，特异度为77.27%。
临床应用与阅片要点
- 日常报告中可优先采用MV-Flow观察子宫内膜病变微血管分布，良性多与恶性多发血管模式不同。
- VIMV≥15.6可作为提示恶性风险的参考界值，但敏感度与特异度均非极高，应结合形态学特征综合判断。
局限性
- 本研究为回顾性病例对照设计。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
AIM: To investigate the value of microvascular flow (MV-Flow) imaging and its quantitative parameter, the vascular index (VIMV), in the differential diagnosis of benign and malignant endometrial lesions, and to compare it with color Doppler flow imaging (CDFI).
MATERIALS AND METHODS: This was a retrospective case-control study including 132 patients with endometrial lesions. Preoperative examinations with CDFI and MV-Flow were performed to assess blood flow visualization and calculate VIMV. Using postoperative histopathological results as the gold standard, receiver operating characteristic (ROC) curve analysis was employed to evaluate and compare the diagnostic performance of VIMV, MV-Flow, and CDFI.
RESULTS: MV-Flow achieved higher overall blood flow detection rates for both benign and malignant lesions (88.63%) and for malignant lesions specifically (100%) compared to CDFI (73.48% and 86.36%, respectively), with clearer visualization of microvessels. The vascular pattern of MV-Flow differed significantly between benign and malignant groups (P<.001), with the malignant group predominantly showing multiple vessels (focal origin and multifocal origin). ROC analysis revealed AUCs for differentiating benign from malignant lesions of 0.872 for VIMV, 0.846 for MV-Flow, and 0.786 for CDFI. Using a VIMV cutoff value of ≥15.6 yielded a diagnostic sensitivity of 79.55% and specificity of 77.27%. Both VIMV and MV-Flow demonstrated significantly higher diagnostic efficacy than CDFI (P=.015 and P=.026, respectively).
CONCLUSION: MV-Flow is superior to CDFI in visualizing microvessels in endometrial lesions and provides richer blood flow information. Its quantitative parameter VIMV has high diagnostic value.
引用
- Li, Zhou, Tang, et al. The value of microvascular flow imaging and color Doppler flow imaging in the differential diagnosis of benign and malignant endometrial lesions. Clin Radiol. 2026. PMID: 42314358. doi:10.1016/j.crad.2026.107388
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。