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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2022, Vol. 19 ›› Issue (02) : 97 -104. doi: 10.3877/cma.j.issn.1672-6448.2022.02.001

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子宫内膜息肉样病变的研究进展
张丹1,†(), 李燕东1   
  1. 1. 100038　北京，首都医科大学附属复兴医院超声科
  • 收稿日期:2021-02-02 出版日期:2022-02-01
  • 通信作者: 张丹

Advances in research of endometrial polypoid lesions

Dan Zhang1(), Yandong Li1   

  • Received:2021-02-02 Published:2022-02-01
  • Corresponding author: Dan Zhang
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张丹, 李燕东. 子宫内膜息肉样病变的研究进展[J]. 中华医学超声杂志（电子版）, 2022, 19(02): 97-104.

Dan Zhang, Yandong Li. Advances in research of endometrial polypoid lesions[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(02): 97-104.

图1 子宫内膜非功能性息肉超声及病理图像。图a为二维超声示息肉内见类圆形无回声区；图b为镜下病理示非功能性息肉内腺体呈囊性扩张（HE ×40），超声与镜下病理表现一致
图2 子宫内膜非功能性息肉超声及病理图像。图a为彩色多普勒超声示息肉内单根粗大供养血管；图b为镜下病理示息肉内粗大的供养血管（HE ×40）
图3 子宫内膜功能性息肉超声及病理图像。图a为彩色多普勒超声示子宫前壁息肉内单根条状血流信号；图b为镜下病理示息肉旁分泌期子宫内膜（HE ×40）；图c为功能性子宫内膜息肉，镜下病理示分泌较其旁内膜差（HE ×40）
图4 子宫腺肌瘤性息肉超声及病理图像。图a为超声图像示瘤体自子宫下段脱入宫颈；图b为镜下病理见腺体、间质及平滑肌组织，息肉顶部糜烂（HE ×40）
图5 子宫腺肌瘤性息肉癌变超声及病理图像。图a为超声图像示宫腔内结节样高回声团伴单根条状血流信号；图b为镜下病理见图像上端为癌变组织（HE ×40）
图6 绝经后子宫内膜息肉超声及病理图像。图a为超声图像示绝经后子宫内膜息肉，息肉样病变充满宫腔，内见类圆形无回声区；图b为镜下病理见腺体囊性扩张、腺上皮增生（HE ×40）；图c为镜下病理见息肉内粗大供养血管及炎性细胞浸润（HE ×40）
图7 子宫内膜息肉癌变的超声及病理图像。图a为二维超声图像示低回声息肉样病变（箭头所示）；图b为镜下病理见息肉体部为非功能性息肉，顶部癌变（HE ×40）
图8 绝经后子宫内膜息肉样增生超声及病理图像。图a为超声图像示宫腔内中高回声息肉样病变伴单根条状血流信号；图b为镜下病理见息肉样病变为子宫内膜局灶性增生过长（HE ×40）
图9 正常子宫内膜的息肉样改变超声、宫腔镜及病理图像。图a为月经周期第10天，二维声像图示子宫内膜息肉样改变，其旁内膜呈增殖期改变；图b为宫腔镜检查见息肉样隆起；图c为息肉样隆起部的镜下病理示子宫内膜呈增殖晚期改变（HE ×40）；图d为息肉样隆起周边子宫内膜变化晚于隆起部，呈增殖早期改变（HE ×40）
图10 月经周期第7天超声检查及宫腔镜手术病理图像。图a为二维超声示息肉样病变脱至宫颈管，周边回声不均；图b为镜下病理示子宫内膜非功能性息肉，表面糜烂（HE ×40）；图c为镜下病理示息肉旁子宫内膜呈单纯增生过长（HE ×40）
图11 功能性子宫内膜息肉超声及病理图像。图a为超声图像示内膜息肉呈高回声伴单根条状血流信号；图b为镜下病理示功能性子宫内膜息肉，息肉内腺体呈分泌期改变伴复杂增生（HE ×100）；图c为镜下病理见息肉旁内膜呈复杂增生（HE ×100）
图12 子宫内膜息肉癌变超声及病理图像。图a为彩色多普勒超声显示息肉样病变的供养血管呈分枝状；图b为镜下病理示息肉癌变（HE ×40）
图13 良性子宫内膜息肉超声及病理图像。图a为彩色多普勒超声示息肉样病变的供养血管呈分枝状；图b为镜下病理示为良性息肉（HE ×40）
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