经阴道超声联合生理盐水灌注直肠子宫陷凹对腹膜型子宫内膜异位症的诊断价值  

Diagnostic value of transvaginal ultrasound combined with saline-infusion sonoPODography in peritoneal endometriosis

作　　者：朱成美 赵巧梅[2] 邓学东[1] Zhu Chengmei;Zhao Qiaomei;Deng Xuedong(Department of Ultrasound,Nanjing Medical University Affiliated Suzhou Hospital,Suzhou 215002,China;Department of Ultrasound,Huaian Maternal and Child Health Hospital,Huaian 223000,China)

机构地区：[1]南京医科大学附属苏州医院超声中心,江苏苏州215002 [2]淮安市妇幼保健院超声科,江苏淮安223000

出　　处：《中华医学超声杂志（电子版）》2024年第1期32-36,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：淮安市市自然科学研究计划(HAB202130)。

摘　　要：目的探讨经阴道超声联合生理盐水灌注直肠子宫陷凹(SPG)对腹膜型子宫内膜异位症的诊断价值。方法选取2022年3月至9月淮安市妇幼保健院收治的50例具有痛经、慢性盆腔痛、性交痛、不孕症状,需要进行腹腔镜手术检查或治疗的患者为研究对象,患者均接受经阴道常规超声及SPG检查,且经腹腔镜及病理组织学最终确诊。统计分析经阴道常规超声及SPG检查在诊断腹膜型子宫内膜异位症的敏感度、特异度、准确性、阳性预测值及阴性预测值,并采用χ^(2)检验比较2种检查方法的差异。结果50例患者,经腹腔镜手术病理检查确诊38例为腹膜型子宫内膜异位症,12例为非腹膜型子宫内膜异位症患者;经阴道常规超声诊断为腹膜型子宫内膜异位症者22例,非腹膜型子宫内膜异位症患者28例;SPG检查诊断为腹膜型子宫内膜异位症者40例,非腹膜型子宫内膜异位症10例。经阴道常规超声检查结果准确性为40.00%(20/50),敏感度为39.47%(15/38)、特异度为41.67%(5/12)、阳性预测值为68.18%(15/22)、阴性预测值为17.86%(5/28),SPG检查结果的准确性为84.00%(42/50)、敏感度为92.11%(35/38)、特异度为58.33%(7/12)、阳性预测值为87.50%(35/40)、阴性预测值为70.00%(7/10),均高于经阴道常规超声检查,差异具有统计学意义(χ^(2)=6.518、27.109、0.114、0.860、1.656,P=0.013、0.006、0.042、0.035、0.029)。结论SPG是诊断腹膜型子宫内膜异位症安全、高效的方法,为早期子宫内膜异位症诊断提供了新方法。Objective To assess the diagnostic value of transvaginal ultrasound combined with saline-infusion sonoPODography(SPG)in peritoneal endometriosis to provide a new diagnostic method for early endometriosis.Methods Fifty patients with dysmenorrhea,chronic pelvic pain,dyspareunia,and infertility who required laparoscopic surgery or treatment were selected as the research subjects at Huaian Maternal and Child Health Hospital from March to September 2022.All patients received routine transvaginal ultrasound and SPG examination,and were finally diagnosed by laparoscopy and histopathology.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of transvaginal ultrasound and SPG in the diagnosis of peritoneal endometriosis were analyzed statistically byχ^(2)test.Results Of the 50 patients included,38 were confirmed as having peritoneal endometriosis by pathological examination after laparoscopic surgery.Fifteen cases were diagnosed with peritoneal endometriosis by conventional transvaginal ultrasonography,and 35 were diagnosed with peritoneal endometriosis by transvaginal ultrasound combined with SPG.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of routine transvaginal ultrasonography for the diagnosis of peritoneal endometriosis were 40.00%(20/50),39.47%(15/38),41.67%(5/12),68.18%(15/22),and 17.86%(5/28),respectively;the corresponding values of SPG were 84.00%(42/50),92.11%(35/38),58.33%(7/12),87.50%(35/40),and 70.00%(7/10).The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of SPG in the detection of peritoneal endometriosis were all significantly higher than those of conventional transvaginal ultrasound(χ^(2)=6.518,27.109,0.114,0.860,and 1.656;P=0.013,0.006,0.042,0.035,and 0.029,respectively).Conclusion SPG is a safe and effective method for the diagnosis of peritoneal endometriosis.

关 键 词：超声检查 经阴道 生理盐水灌注 直肠子宫陷凹 早期诊断 子宫内膜异位症 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.71[医药卫生—诊断学]