目的:探讨三维能量多普勒超声(3D-PDUS)在子宫内膜息肉鉴别诊断中的应用。方法:回顾性分析2016年12月至2019年12月南阳市第一人民医院收治的106例拟诊为子宫内膜息肉或子宫黏膜下肌瘤患者的临床资料，所有患者均行3D-PDUS检查。以病理检查结果作为金标准，评估3D-PDUS检查结果对子宫内膜息肉、子宫黏膜下肌瘤的诊断应用价值，计算灵敏度、特异度及准确率。比较子宫内膜息肉及子宫黏膜下肌瘤患者3D-PDUS相关血流参数[血管指数(VI)、血流指数(FI)、血管-血流指数(VFI)]及特异性超声征象。结果:106例患者的病理检查结果显示子宫内膜息肉患者64例(子宫内膜息肉组)，其中单发33例，多发31例；子宫黏膜下肌瘤42例(子宫黏膜下肌瘤组)。3D-PDUS检查诊断结果为子宫内膜息肉59例，子宫黏膜下肌瘤47例，对照病理结果其误诊7例，误诊率为7.81%，灵敏度、特异度、准确率分别为98.31%、87.23%、93.40%，子宫内膜息肉预测值为90.63%，子宫黏膜下肌瘤预测值为97.62%。子宫内膜息肉组患者VI、FI、VFI均低于子宫黏膜下肌瘤组，差异有统计学意义(n P<0.05)；两组患者在回声等级、有无周边声晕、肿块大小、肿块形态、显像内膜夹角等方面比较差异有统计学意义(n P<0.05)。n 结论:3D-PDUS可清晰直观的显示子宫内膜息肉患者的病灶部位及形态，临床诊断价值较高，可有效鉴别区分与其在临床症状及超声影像上较为相似的子宫黏膜下肌瘤。“,”Objective:To investigate the application of three-dimensional powder Doppler ultrasound (3D-PDUS) in the differential diagnosis of endometrial polyps.Methods:The clinical data of 106 patients who were diagnosed as possible endometrial polyps or uterine submucosal fibroids from December 2016 to December 2019 were retrospectively analyzed. All patients underwent 3D-PDUS examination. Using the pathological examination results as the gold standard, the diagnostic application value of 3D-PDUS examination results on endometrial polyps and uterine submucosal fibroids was evaluated, and the sensitivity, specificity and accuracy rate were calculated. The 3D-PDUS related blood flow parameters, such as vascular index (VI), blood flow index (FI), vascular-blood flow index (VFI), and specific ultrasound signs of patients with endometrial endometrial polyps and patients with uterine submucosal fibroids were compared.Results:Pathological examination showed 64 cases of endometrial polyps (endometrial polyps group, including 33 single cases and 31 multiple cases) and 42 cases of uterine submucosal fibroids (uterine submucosal fibroids group). 3D-PDUS examination showed 59 cases of endometrial polyps and 47 cases of uterine submucosal fibroids, and 7 cases were misdiagnosed according to the pathological results, with a misdiagnosis rate of 7.81%. The sensitivity, specificity, and accuracy rate were 98.31%, 87.23% and 93.40%, respectively. The predicted value of endometrial polyps was 90.63%, and the predictive value of uterine submucosal fibroids was 97.62%. The VI, FI and VFI in endometrial polyps group were significantly lower than those in uterine submucosal fibroids group (n P<0.05). There were significant differences in the echo grading, presence or absence of peripheral halo, tumor size, tumor morphology and imaging intima angle between the two groups (n P<0.05).n Conclusions:3D-PDUS can clearly and intuitively display the lesion location and morphology of patients with endometrial polyps, and has high clinical diagnostic value, and can effectively distinguish from uterine submucosal fibroids that are more similar to the clinical symptoms and ultrasound images.