经阴道三维超声检查定量对宫腔粘连的诊断价值  

Diagnosis of intrauterine adhesions with quantitative three-dimensional ultrasound through vagina

作　　者：高洁 唐春莲 丁学谨 陈丹丹 GAO Jie;TANG Chunlian;DING Xuejin;CHEN Dandan(Wuhan Wuchang Hospital,Wuhan University of Science and Technology,Wuhan 430081,China)

机构地区：[1]武汉科技大学附属武汉市武昌医院,湖北武汉430081

出　　处：《医学影像学杂志》2023年第7期1223-1227,共5页Journal of Medical Imaging

基　　金：湖北省科技计划项目(编号:2017CFA069)。

摘　　要：目的探讨经阴道三维超声检查定量对宫腔粘连诊断临床应用价值及特异性、准确性、敏感度。方法选取我院宫腔粘连疑似患者150例,术前对患者行经阴道三维及二维超声检查,150例宫腔粘连疑似患者,确诊宫腔粘连患者136例。并依据March分类标准将宫颈粘连度分为重度、中度、轻度3组。将宫腔镜诊断结果作为金标准,比较经阴道三维超声与常规经阴道二维超声检查诊断特异性、准确性、敏感度,分析内膜血流参数与子宫内膜容积差异。结果二维超声检查诊断特异性、准确率、敏感度分别为41.2%、77.3%、75%。二维超声检查与三维超声检查诊断特异性分别为41.2%、70.0%,准确率分别为77.3%、96.0%,敏感度分别为75%、95.6%,二维超声检查与三维超声检查诊断价值差异有统计学意义,与二维超声检查比较,宫腔镜诊断价值更高(P<0.05);与宫腔正常患者比较,轻、中、重度宫腔粘连患者内膜体积更小(P<0.05),中度与重度宫腔粘连患者VI、FI、VFI差异有统计学意义(P<0.05),正常与轻度粘连患者VI、FI、VFI差异无统计学意义(P>0.05)。结论对宫腔粘连患者应用经阴道三维超声检查诊断具有较强识别性和较高准确率,定量测量内膜血流参数和容积可提高宫腔粘连诊断精确度,有利于粘连程度评价。Objective To investigate the clinical application value,specificity,accuracy and sensitivity of transvaginal three-dimensional ultrasound in the diagnosis of intrauterine adhesions.Methods A total of 150 patients with suspected intrauterine adhesions were selected.The patients underwent transvaginal three-dimensional and two-dimensional ultrasound examinations before the operation.After diagnosis,150 patients with suspected intrauterine adhesions were diagnosed with intrauterine adhesions.There were 136 patients.According to March classification criteria,cervical adhesions were divided into three groups:severe,moderate,and mild.The diagnosis result of hysteroscopy was used as the gold standard to compare the specificity,accuracy and sensitivity of transvaginal three-dimensional ultrasound and conventional two-dimensional transvaginal ultrasound,and to analyze the difference between endometrial blood flow parameters and endometrial volume.Results The specificity,accuracy and sensitivity of two-dimensional ultrasound diagnosis were 41.2%,77.3%,and 75%,respectively.The diagnostic specificities of two-dimensional ultrasound and three-dimensional ultrasound were 41.2%and 70.0%,respectively,the accuracy rates were 77.3%,96.0%,and the sensitivity was 75.0%and 95.6%,respectively.The diagnostic value of two-dimensional ultrasound and three-dimensional ultrasound was statistically significant.Compared with two-dimensional ultrasound,the diagnostic value of hysteroscopy was higher(P<0.05);compared with patients with normal uterine cavity,patients with mild,moderate,and severe intrauterine adhesions had smaller intimal volume(P<0.05),moderate and VI,FI,and VFI in patients with moderate intrauterine adhesions were statistically significant(P<0.05),and there was no statistical significance in VI,FI,and VFI in patients with normal and mild adhesions(P>0.05).Conclusion The application of transvaginal three-dimensional ultrasound diagnosis to patients with intrauterine adhesions has strong recognition and high accuracy.Quantitati

关 键 词：经阴道三维超声检查 宫腔粘连 

分 类 号：R445.1[医药卫生—影像医学与核医学] R713.4[医药卫生—诊断学]