经阴道三维自由解剖成像联合宫腔声学造影对宫腔粘连的临床价值分析  

Combination of 3D-TVS with Omniview technique and SHG to evaluate intrauterine adhesions

作　　者：向小珍 胡兵[1] 吴齐英 杨莹 丁凌[1] XIANG Xiao-zhen;HU Bing;WU Qi-ying;YANG Ying;DING Ling(Department of Ultrasonic Imaging,the Affiliated Renhe Hospital of Three Gorges University,Yichang Hubei 443001,China)

机构地区：[1]三峡大学附属仁和医院超声科,湖北宜昌443001

出　　处：《中国临床医学影像杂志》2022年第11期805-809,共5页Journal of China Clinic Medical Imaging

基　　金：宜昌市医疗卫生研究项目(编号A21-2-040)

摘　　要：目的:研究经阴道三维自由解剖成像(Omniview)联合宫腔声学造影(SHG)诊断宫腔粘连(IUA)及其严重程度、分型的临床价值。方法:选择2020年11月—2022年3月在医院就诊的102例疑似IUA病人为研究对象,每个入选者均进行了经阴道三维超声和SHG检查,选择Omniview模式进行宫腔三维成像。金标准为宫腔镜检查,分析Omniview联合SHG检查对IUA及其严重程度、分型的诊断效能。结果:102例疑似IUA患者,宫腔镜检查显示79例粘连,非粘连为23例,其中轻、中、重度粘连分别为29例、35例、15例;周围型、中央型及混合型粘连分别为33例、25例、21例。Omniview联合SHG诊断IUA的总准确率达94.12%,与宫腔镜比较,差异无统计学意义(P=0.69>0.05),两种检查方式一致性较好(Kappa值为0.837,P<0.05)。本研究对79例宫腔镜检查确诊的IUA患者进行严重程度及分型对比发现,Omniview联合SHG检查对IUA严重程度及分型的总体准确率分别为93.67%、92.41%。结论:Omniview联合SHG检查对IUA具有较高的诊断价值,可显著区分不同程度及分型的IUA,值得临床推广使用。Objective:To investigate the clinical value of three-dimensional transvaginal sonography(3D-TVS)with Omniview technique combined with sonohysterography(SHG)in the diagnosis,severity evaluation,and classification of intrauterine adhesions(IUA).Methods:From November 2020 to March 2022,102 suspected IUA patients were included in this study.Each patients underwent combined examinations of 3D-TVS with Omniview technique and SHG.The hysteroscopy was treated as the gold standard.The diagnostic efficacy of 3D-TVS with Ominview technique combined with SHG was analyzed on diag-nosis,severity and classification in IUA.Results:Of the 102 suspected IUA patients,there were 79 cases with adhesion and23 cases without adhesion.There were 29 cases with mild adhesion,35 cases with moderate adhesion,and 15 cases with severe adhesion,33 cases with peripheral adhesion,25 cases with central adhesion and 21 cases with hybrid adhesion,respec-tively.The overall accuracy of 3D-TVS with Omniview technique combined with SHG was 94.12%.There was no significant difference between combined examinations and hysteroscopy(P>0.05).It showed good consistency between 3D-TVS with Omniview technique and SHG(P<0.05).In this study,the severity and classification of IUA was compared between 3D-TVS with Omniview technique and SHG in 79 patients with IUA.By 3D-TVS with Omniview technique combined with SHG,the overall accuracy of severity and classification of IUA was 93.67%and 92.41%,respectively.Conclusions:3D-TVS with Omniview technique combined with SHG not only has high diagnostic performance in IUA,but also has good discrimination in the severity and classification of IUA,which is worthy of clinical application.

关 键 词：子宫疾病 超声检查 多普勒 彩色 宫腔镜检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.74[医药卫生—诊断学]