经阴道二维超声、三维超声容积成像及能量多普勒超声在宫腔粘连诊断中的联合应用  

Combined application of transvaginal two-dimensional ultrasound, three-dimensional ultrasound volume imaging and three-dimensional power Doppler ultrasound in the diagnosis of intrauterine adhesions

作　　者：宋蕾[1] 王一凡[1] 林冲[1] 张丽[1] 许瑶璇[1] 左云鹏[1] SONG Lei;WANG Yi-fan;LIN Chong;ZHANG Li;XU Yao-xuan;ZUO Yun-peng(Department of Ultrasound, Xuzhou Maternity and Child Health Care Hospital, Xuzhou Jiangsu 221009, China)

机构地区：[1]徐州市妇幼保健院超声科

出　　处：《中国临床医学影像杂志》2019年第5期342-345,367,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨经阴道二维超声(2D-TVS)、三维超声(3D-TVS)容积成像及三维能量多普勒超声(3D-PDUS)在联合诊断宫腔粘连(IUA)中的应用价值。方法:采用2D-TVS、3D-TVS容积成像、3D-PDUS分别对89例临床疑诊IUA的已婚妇女进行检查,并获得超声参数:包括内膜厚度(ED)、内膜容积(EV)、血管指数(VI)、血流指数(FI)以及血管-血流综合指数(VFI)。随后根据宫腔镜(HS)检查结果将患者分为宫腔正常组、轻度粘连组、中度粘连组、重度粘连组,回顾性分析IUA的超声准确率及图像特点,比较四组间ED、EV、VI、FI及VFI的差异。结果:2D-TVS联合3D-TVS诊断IUA的Youden指数为0.793、灵敏度为91.8%、特异度为87.5%,与HS诊断符合率为91.0%。四组间EV比较有统计学差异(P均<0.05);宫腔正常组分别与轻、中、重度IUA组,轻度组和重度粘连组间ED、VI、VFI两两比较均具有统计学差异(P均<0.05)。结论:联合应用2D-TVS、3D-TVS容积成像、3D-PDUS能为IUA提供更准确、直观、全面的诊断信息,具有较高的临床应用价值。Objective: To evaluate the application value of the combination of transvaginal two-dimensional ultrasound(2DTVS), three-dimensional ultrasound(3D-TVS) volume imaging and power Doppler ultrasound(3D-PDUS) in the diagnosis of intrauterine adhesions (IUA). Methods: 89 females suspected with intrauterine adhesions were examined separately with 2D-TVS, 3D-TVS, 3D-PDUS. Ultrasound parameters were recorded respectively, including endometrial thickness(ED), endometrial volume (EV) and vascularization index(VI), flow index (FI) and vascularization -flow index(VFI). According to the hysteroscopy(HS), the patients were divided into normal group, mild adhesion group, moderate adhesion group and severe adhesion group. The ultrasonic accuracy and image characteristics of IUA were analyzed, and the varieties of the ultrasound parameters were compared among four groups retrospectively. Results: The sensitivity, specificity, Youden index of the combination of 2D-TVS and 3DTVS in the diagnosis of intrauterine adhesions were 91.8%, 87.5%, 0.793, and the diagnostic accordance rate with HS was 91.0%. Indicators EV of each group had statistical significance(all P<0.05). ED, VI and VFI were significant different between the normal group and mild, moderate, severe adhesion groups, as well as between mild and severe adhesion groups (all P< 0.05). Conclusion: The combination of 2D-TVS, 3D-TVS volume imaging and 3D-PDUS can provide more accurate, direct and comprehensive diagnostic information for intrauterine adhesions,which has high clinical practical value.

关 键 词：子宫疾病 超声检查 多普勒 彩色 

分 类 号：R711.74[医药卫生—妇产科学] R445.1[医药卫生—临床医学]