经阴道三维超声血流参数诊断宫腔粘连及评估病情程度效能  

Efficacy of blood flow parameters by three-dimensional transvaginal ultrasound for diagnosing intrauterine adhesion and the evaluation of its severity

作　　者：李思敏 丁芸 LI Simin;DING Yun(Meishan Maternal and Child Health Care Hospital,Meishan,Sichuan Province,620500)

机构地区：[1]四川省眉山市妇幼保健院,620500

出　　处：《中国计划生育学杂志》2023年第4期880-883,888,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨经阴道三维超声(3D-TVS)血流参数诊断宫腔粘连(IUA)效果及与病情程度关系。方法:收集2019年3月-2021年12月在本院就诊的96例IUA患者为IUA组,体检正常女性82例为对照组,均行3D-TVS检查,IUA组以宫腔镜诊断结果为金标准,评估3D-TVS诊断的准确性并分析其诊断效能;测定两组血流参数[内膜区血管指数(VI)、血管血流指数(VFI)、血流指数(Flow index, FI)和子宫内膜容积(EV)];按照IUA分级标准将IUA患者分为I~III级,比较不同分级患者血流参数及与IUA分级的相关性。结果:96例IUA患者中3D-TVS诊断IUA 91例,准确率为94.8%,灵敏度94.8%、特异度97.6%、阳性预测值97.9%,阴性预测值94.1%;IUA组EV、FI、VFI、VFI均低于对照组(P<0.05),且随着IUA分级升高EV、FI、VFI和VFI依次降低(P<0.05);EV、FI、VFI、VFI均与IUA分级呈负相关(P<0.05)。结论:3D-TVS诊断IUA效能较高,各血流参数与宫腔粘连程度呈负相关,可用于病情的评估。Objective:To explore the efficacy of the blood flow parameters of patients by threerdimensional transvaginal ultrasound(3D-TVS)for diagnosing their intrauterine adhesion(IUA),and to study the correlation between the blood flow parameters of the women and the severity of their IUA.Methods:96 women with IUA were enrolled in study group between March 2019 and December 2021,and other 82 normal women who underwent physical exa mination were enrolled in control group during the same period.All these women had undergone 3D TVS examination.In study group,the diagnosis accuracy of 3D TVS for IUA was evaluated and the diagnostic efficiency was analyzed based on the hysteroscopy results of IUA as the golden standard.The blood flow parameters,such as endometrial vascular index(VI),vasularization flow index(VFI),flow index(FD),and endometrial volume(EV)of the women in both groups were detected.According to grading standard of IUA,the women in the study group included the women with grade I grade of IUA in group A,the women with gradelI of IUA in group B,and the women with grade III of IUA in group C.The correlation of the blood flow parameters values of the women with IUA and their different grade of IUA was analyzed.Results:Among 96 women with IUA,91 cases were diagnosed as IUA by 3D-TVS,with the accuracy of 94.8%,the sensitivity of 94.8%,the specificity of 97.6%,the positive predictive value of 97.9%,and the negative predictive value of 94.1%.The values of EV,FI,VFI,and VFI of the women in the study group were significantly lower than those of the women in the control group(P<0.05),and which of the women in group A,in group B,and in group C had decreased gradully(P<0.05).The values of EV,FI,VFI,and VFI of the women with IUA were negatively correlated with their IUA grading(P<0.05).Conclusion:3D-TVS examination of the women for diagno-sing their IUA has higher efficacy.The blood flow parameters values of the women by 3D-T VS are negatively correlated with their severity of IUA,and which can be applied in the disease assessme

关 键 词：宫腔粘连 分级 经阴道三维超声 血流参数 诊断效能 病情评估 

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]