经阴道二维超声检查在诊断宫腔粘连中的应用  

Application of 2D Transvaginal Ultrasonography in the Diagnosis of Intrauterine Adhesions

作　　者：于俊欣[1] 张丁丁[1] 王浩[2] 安娜[1] 刘广会[1] 张旭[1] 赵小琪 YU Junxin;ZHANG Dingding;WANG Hao;AN Na;LIU Guanghui;ZHANG Xu;ZHAO Xiaoqi(Department of Ultrasound,Wangjing Hospital,China Academy of Traditional Chinese Medicine,Beijing 100102,China;Department of Gynecology,Wangjing Hospital,China Academy of Traditional Chinese Medicine,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院超声科,北京100102 [2]中国中医科学院望京医院妇科,北京100102

出　　处：《临床误诊误治》2024年第13期66-70,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2023年度北京市中医药科技发展资金项目拟立项重点项目(JJ-2023-107)。

摘　　要：目的探究经阴道二维超声诊断宫腔粘连的应用价值。方法研究组选取2022年1月至2024年1月收治的70例宫腔粘连患者,对照组则为同期接受健康体检的70例女性,均进行阴道二维超声检查。比较2组的超声参数子宫动脉搏动指数(PI)、阻力指数(RI)、收缩期流速与舒张期流速比值(S/D)以及子宫内膜厚度,并比较不同程度宫腔粘连患者上述指标情况,分析宫腔粘连程度与上述指标的相关性。采用受试者工作特征(ROC)曲线评价经阴道二维超声对宫腔粘连的诊断效能。结果研究组子宫动脉PI、RI、S/D高于对照组,子宫内膜厚度低于对照组(P<0.01)。随着宫腔粘连程度的加重,患者PI、RI、S/D呈逐渐上升趋势,子宫内膜厚度呈逐渐下降趋势(P<0.01);宫腔粘连程度与PI、RI、S/D呈正相关,而与子宫内膜厚度呈负相关(P<0.05)。ROC曲线分析显示,PI、RI、S/D、子宫内膜厚度诊断宫腔粘连的曲线下面积(AUC)分别为0.684、0.634、0.814、0.671,4项联合诊断宫腔粘连的AUC为0.905。结论经阴道二维超声能较好评估宫腔粘连患者的粘连程度与子宫内膜情况。Objective To explore the application value of 2-dimensional(2D)transvaginal ultrasonography(TVUS)in the diagnosis of intrauterine adhesions(IUA).Methods A total of 70 patients with IUA from January 2022 to January 2024 were selected as the research group,and another 70 women who underwent physical examination during the same period were enrolled as the control group.Both groups received 2D TVUS.The ultrasonic parameters of the two groups were compared,including uterine artery pulsatility index(UAPI),resistance index(RI),systolic to diastolic velocity ratio(S/D)and endometrial thickness;the above indexes of patients with different grades of IUA were compared,and the correlation between the degree of IUA and the above indexes was analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of 2D TVUS for IUA.Results The UAPI,RI and S/D in the research group were higher than those in the control group,while the endometrial thickness was lower than that in the control group(P<0.01).With the aggravation of IUA,PI,RI and S/D showed a gradual increase,while endometrial thickness showed a gradual decrease(P<0.01).The degree of IUA was positively correlated with PI,RI and S/D,but negatively correlated with endometrial thickness(P<0.05).ROC curve analysis showed that the area under the ROC curve(AUC)of PI,RI,S/D and endometrial thickness in the diagnosis of IUA were 0.684,0.634,0.814 and 0.671,respectively,and the AUC of the combined detection for the diagnosis of IUA was 0.905.Conclusion 2D TVUS can better evaluate the degree of adhesion and endometrium in patients with IUA.

关 键 词：宫腔粘连 阴道二维超声 宫腔镜检查 诊断 搏动指数 阻力指数 子宫内膜厚度 受试者工作特征 

分 类 号：R711.74[医药卫生—妇产科学]