三维经阴道超声对宫腔粘连患者宫腔容积及血流变化的评估  

Evaluation of Three-dimensional Transvaginal Ultrasound in Uterine Volume and Blood Flow in Patients with Intrauterine Adhesions

作　　者：刘莎[1] 陈娇[1] 陈文[1] 仇萌萌 林叶 LIU Sha;CHEN Jiao;CHEN Wen;QIU Mengmeng;LIN Ye(Shiyan Maternal and Child Health Hospital,Shiyan 442000,Hubei,P.R.China)

机构地区：[1]十堰市妇幼保健院,湖北十堰442000

出　　处：《影像科学与光化学》2020年第3期436-440,共5页Imaging Science and Photochemistry

摘　　要：为了观察宫腔粘连患者行三维经阴道超声(3D-TVS)检查时宫腔容积及血流的变化,本文纳入2016年11月~2018年11月于我院收治的68例宫腔粘连患者为观察组,另选取同期来我院体检的健康女性68例为对照组,均于月经周期中晚期行3D-TVS检查,并以病理诊断结果为金标准,观察了3D-TVS诊断宫腔粘连的灵敏度及特异度。同时,对比了两组患者3D-TVS参数如子宫内膜容积(EV)、血流指数(FI)、血管血流指数(VFI)及内膜区血管指数(VI)的变化,并分析了宫腔粘连不同分级患者上述3D-TVS参数的变化情况。经病理确诊的68例患者中,3D-TVS诊断为宫腔粘连64例,其中Ⅰ型21例,Ⅱ型31例,Ⅲ型9例,Ⅳ型3例。3D-TVS诊断宫腔粘连的灵敏度为92.65%,特异度为98.53%,准确率为95.59%,阳性预测值为98.44%,阴性预测值为93.06%,Kappa值为0.91。观察组EV、FI、VFI、VI均显著低于对照组。Ⅰ型宫腔粘连者EV显著大于Ⅱ、Ⅲ、Ⅳ型者,Ⅱ型宫腔粘连者EV显著大于Ⅲ、Ⅳ型者,Ⅲ型宫腔粘连者EV显著大于Ⅳ型者;Ⅰ型宫腔粘连者的VFI、VI显著大于Ⅲ、Ⅳ型者。上述结果证实3D-TVS对宫腔粘连患者宫腔容积及血流变化具有重要的评估价值。In this article,with three-dimensional transvaginal ultrasound(3D-TVS),the changes of uterine volume and blood flow in patients with intrauterine adhesions were observed.68 cases of intrauterine adhesion from November 2016 to November 2018 were included as the observation group,and 68 healthy women who came to our hospital for physical examination during the same period were selected as the control group.All of them underwent 3D-TVS examination in the middle and late menstrual cycle,and the sensitivity and specificity were observed with the pathological diagnosis as the gold standard.At the same time,the changes of 3D-TVS parameters such as endometrial volume(EV),blood flow index(FI),blood flow index(VFI)and intimal vascular index(VI)in the two groups were compared,and the changes of the above parameters in patients with different levels of intrauterine adhesion were compared.Among 68 cases confirmed by pathology,64 cases were diagnosed by 3D-TVS,including 21 cases of typeⅠ,31 cases of typeⅡ,9 cases of typeⅢand 3 cases of typeⅣ.The sensitivity of 3D-TVS was 92.65%,the specificity was 98.53%,the accuracy was 95.59%,the positive predictive value was 98.44%,the negative predictive value was 93.06%,the kappa value was 0.91.The EV,FI,VFI and VI in the observation group were significantly lower than those in the control group.EV in typeⅠwas significantly higher than that in typeⅡ,ⅢandⅣ;EV in typeⅡwas significantly higher than that in typeⅢandⅣ(P<0.05);EV in typeⅢwas significantly higher than that in typeⅣ;VFI and VI of typeⅠwere significantly higher than those of typeⅢandⅣ.The above results confirmed that 3D-TVS had an important value in evaluating the changes of uterine volume and blood flow in patients with intrauterine adhesions.

关 键 词：经阴道三维超声 宫腔粘连 宫腔容积 血流参数 

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]