经阴道三维超声检查对宫腔粘连的诊断价值及漏诊原因分析  

Diagnostic value of 3D-TVS in intrauterine adhesions and causes of missed diagnosis

作　　者：黄丽娜[1] 何秀珍[1] HUANG Li’na;HE Xiuzhen(Department of Ultrasound,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院超声科,广东佛山528000

出　　处：《陕西医学杂志》2021年第4期421-424,共4页Shaanxi Medical Journal

基　　金：广东省佛山市卫生健康委员会医学科研课题(20200373)。

摘　　要：目的:探究经阴道三维超声(3D-TVS)检查对宫腔粘连的诊断价值及漏诊原因。方法:回顾性分析265例经宫腔镜及病理确诊为宫腔粘连患者资料,比较经阴道二维超声及3D-TVS诊断准确率、不同宫腔粘连粘连程度患者经3D-TVS扫描宫腔粘连子宫声像图结果,并分析漏诊患者原因。结果:经3D-TVS诊断宫腔粘连总体准确率显著高于二维超声,并且对轻度宫腔粘连检出准确率明显优于二维超声(均P<0.05);3D-TVS与二维超声对中度、重度宫腔粘连检出准确率差异无统计学意义(均P>0.05)。应用二维超声将轻度宫腔粘连漏诊为正常宫腔57例(21.51%);3D-TVS漏诊10例(3.77%),两种检查方法漏诊率比较差异有统计学意义(P<0.05)。结论:经3D-TVS检查,可直观显示出宫腔粘连患者粘连程度及分型,可结合患者临床表现进行有效诊断,同时需注意易引起漏诊的因素,以提高诊断准确率。Objective:To explore the diagnostic value of transvaginal three-dimensional ultrasound(3D-TVS)in intrauterine adhesions and the causes of missed diagnosis.Methods:The data of 265 patients with intrauterine adhesions diagnosed by hysteroscopy and pathology were retrospectively analyzed.The diagnostic accuracy of transvaginal two-dimensional ultrasound and 3D-TVS,the results of 3D-TVS in patients with different degrees of intrauterine adhesions were compared,and the causes of missed diagnosis were analyzed.Results:The overall accuracy of 3D-TVS in the diagnosis of intrauterine adhesions was significantly higher than that of two-dimensional ultrasound,and the detection accuracy of mild intrauterine adhesions was significantly better than that of two-dimensional ultrasound(all P<0.05).There was no significant difference in the detection accuracy of moderate and severe intrauterine adhesions between 3D-TVS and two-dimensional ultrasound(all P>0.05).A total of 57 cases(21.51%)of mild intrauterine adhesions were misdiagnosed as normal intrauterine adhesions by two-dimensional ultrasound,and 10 cases(3.77%)were misdiagnosed by 3D-TVS.There was significant difference in the rate of misdiagnosis between the two methods(P<0.05).Conclusion:3D-TVS examination can directly show the degree and type of intrauterine adhesions in patients,which can be combined with the clinical manifestations of patients for effective diagnosis.At the same time,it is necessary to pay attention to the factors that are easy to cause missed diagnosis,so as to improve the accuracy of diagnosis.

关 键 词：经阴道三维超声 经阴道二维超声 宫腔粘连 诊断 漏诊 

分 类 号：R711.74[医药卫生—妇产科学]