阴道三维超声在宫腔粘连诊断及严重度评估中的应用效能研究  

The Application Efficacy of Three-Dimensional Vaginal Ultrasound in the Diagnosis and Severity Assessment of Intrauterine Adhesions

作　　者：郭艳燕 张望金 GUO Yan-yan;ZHANG Wang-jin(Department of Ultrasound,Longyan First Hospital Affiliated to Fujian Medical University,Fujian Longyan 364000)

机构地区：[1]福建医科大学附属龙岩第一医院超声科,福建龙岩364000

出　　处：《中国医疗器械信息》2024年第12期10-12,172,共4页China Medical Device Information

摘　　要：目的:探讨阴道三维超声在宫腔粘连(intrauterine adhesions,IUA)临床诊断及严重度评估中的效能。方法:将2020年1月~2023年9月本院诊治的60例疑似宫腔粘连接受宫腔镜检查术患者纳入研究,均术前接受阴道二维、三维超声检查。根据宫腔镜检结果,分为无粘连组、轻度组、中度组、重度组,分析阴道三维超声诊断效能,并分析不同严重度患者子宫内膜容积(EV)、血管化指数(V)、血流指数(FI)及血管化血流指数(VFI),绘制受试者工作特征(ROC)曲线评估阴道三维超声在宫腔粘连评估中的效能。结果:本组患者经宫腔镜检查,共确诊宫腔粘连43例(71.67%),包括轻度17例、中度19例、重度7例。通过分析,阴道三维超声的诊断敏感度、特异度及准确度均高于二维超声(P<0.05)。通过测定,轻度组、中度组、重度组EV均显著低于无粘连组(P<0.05);中度组、重度组V、FI、VFI均低于无粘连组(P<0.05);中度组、重度组EV、VI、FI、VFI均显著低于轻度组(P<0.05),重度组均低于中度组(P<0.05)。通过ROC曲线分析,EV、VI、FI、VFI联合评估宫腔粘连严重度AUC为0.917。结论:阴道三维超声诊断IUA及其严重度有重要价值,内膜相关参数定量测定有着良好效能。Objective:To investigate the efficacy of three-dimensional vaginal ultrasound in the clinical diagnosis and severity assessment of intrauterine adhesions(IUA).Methods:60 patients with suspected intrauterine adhesions who underwent hysteroscopy in our hospital from January 2020 to September 2023 were included in the study,and all of them received two-dimensional and three-dimensional vaginal ultrasonography before surgery.According to the results of hysteroscopy,patients were divided into non-adhesion group,mild group,moderate group and severe group.The diagnostic efficacy of three-dimensional vaginal ultrasound was analyzed,and endometrial volume(EV),vascularization index(V),blood flow index(FI)and vascularization blood flow index(VFI)of patients with different severity were analyzed.Receiver operating characteristic(ROC)curve was plotted to evaluate the efficacy of three-dimensional vaginal ultrasound in the evaluation of uterine adhesions.Results:In this group,a total of 43 cases(71.67%)of uterine adhesions were confirmed by hysteroscopy,including 17 cases of mild,19 cases of moderate,and 7 cases of severe.The diagnostic sensitivity,specificity and accuracy of three-dimensional vaginal ultrasound were higher than those of two-dimensional ultrasound(P<0.05).EV in mild,moderate and severe groups was significantly lower than that in non-adhesion group(P<0.05).The V,FI and VFI in moderate and severe groups were lower than those in non-adhesion group(P<0.05).EV,VI,FI and VFI in moderate and severe groups were significantly lower than those in mild group(P<0.05),and those in severe group were lower than those in moderate group(P<0.05).According to ROC curve analysis,the AUC of intrauterine adhesion severity evaluated by EV,VI,FI and VFI was 0.917.Conclusion:Three-dimensional vaginal ultrasonography has important value in the diagnosis of IUA and its severity,and the quantitative determination of endometria-related parameters has good efficacy.

关 键 词：阴道三维超声 宫腔粘连 诊断 严重度 评估 

分 类 号：R445.1[医药卫生—影像医学与核医学]