经阴道彩色多普勒超声联合三维容积成像技术在子宫内膜病变诊断中的应用价值  

Application Value of Transvaginal Color Doppler Ultrasound Combined with Three-Dimensional Volume Imaging in the Diagnosis of Endometrial Lesions

作　　者：肖佳 高雅丽 张威[2] XIAO Jia;GAO Yali;ZHANG Wei(Department of Ultrasound Medicine,Nanyang First People's Hospital,Nanyang 473000,China;Department of Pathology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]南阳市第一人民医院超声医学科,河南南阳473000 [2]郑州大学第三附属医院病理科,河南郑州450052

出　　处：《临床医学工程》2025年第2期145-148,共4页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20190332)。

摘　　要：目的探讨经阴道彩色多普勒超声(TVCDU)联合三维容积成像技术(3DVI)在子宫内膜病变诊断中的应用价值。方法选取2021年7月至2023年8月南阳市第一人民医院收治的88例疑似子宫内膜病变患者作为研究对象,均行TVCDU、3DVI检查。以病理组织学检查结果作为诊断“金标准”,统计TVCDU、3DVI及联合检查诊断子宫内膜病变良恶性的结果;对比TVCDU、3DVI及联合检查诊断不同类型子宫内膜病变患者的结果,并对比不同检查方法对子宫内膜病变的诊断效能,分析TVCDU、3DVI及联合检查与病理组织学检查结果的一致性。结果病理组织学检查结果显示,88例疑似子宫内膜病变患者中58例确诊为子宫内膜病变良性,30例确诊为子宫内膜病变恶性;TVCDU检查检出良性54例,恶性34例;3DVI检查检出良性53例,恶性35例;联合检查检出良性57例,恶性31例。TVCDU与联合检查对子宫腺肌病的检出率比较有统计学差异(P<0.05);其他类型子宫内膜病变患者在不同检查方法下检出率比较,均无统计学差异(P>0.05)。TVCDU与3DVI检查、TVCDU与联合检查诊断子宫内膜病变的效能情况比较,均有统计学差异(P<0.05);3DVI与联合检查诊断子宫内膜病变的效能情况比较,无统计学差异(P>0.05)。Kappa一致性检验结果显示,TVCDU诊断与病理检查结果一致性不佳(Kappa值=0.265,P=0.012),3DVI、联合诊断与病理检查结果一致性均良好(Kappa值=0.781、0.925,P=0.000、0.000),且联合诊断的Kappa值高于TVCDU、3DVI单独诊断。结论TVCDU联合3DVI检查在子宫内膜病变诊断中应用价值较高,能够提高不同类型子宫内膜病变的检出率,且与病理组织学检查结果具有较强的一致性。Objective To explore the application value of transvaginal color Doppler ultrasound(TVCDU)combined with three-dimensional volume imaging(3DVI)in the diagnosis of endometrial lesions.Methods 88 patients with suspected endometrial lesions admitted to the Nanyang First People's Hospital from July 2021 to August 2023 were selected as the study subjects.All patients underwent TVCDU and 3DVI examinations.The results of histopathological examination were used as the gold standard for diagnosis,and the results of TVCDU,3DVI and combined examination in the diagnosis of benign and malignant endometrial lesions were statistically analyzed.The results of TVCDU,3DVI and combined examination in the diagnosis of different types of endometrial lesions were compared,and the diagnostic efficacy of different examination methods for endometrial lesions was compared.The consistency of TVCDU,3DVI and combined examination with histopathological examination results was analyzed.Results The results of histopathological examination showed that 58 cases of 88 patients with suspected endometrial lesions were diagnosed as benign endometrial lesions and 30 cases were diagnosed as malignant endometrial lesions.TVCDU detected 54 cases of benign and 34 cases of malignant,3DVI detected 53 cases of benign and 35 cases of malignant,combined examination detected 57 cases of benign and 31 cases of malignant.There was significant difference in the detection rate of adenomyosis between TVCDU and combined examination(P<0.05);no significant difference in the detection rate of other types of endometrial lesions under different examination methods(P>0.05).There was statistically significant difference in the diagnostic efficacy of TVCDU and 3DVI examination,as well as TVCDU and combined examination for endometrial lesions(P<0.05);no significant difference in the efficacy of 3DVI and combined examination in diagnosing endometrial lesions(P>0.05).Kappa consistency test results showed that the consistency between TVCDU diagnosis and pathological examination r

关 键 词：子宫内膜病变 经阴道彩色多普勒超声 三维容积成像 一致性 

分 类 号：R445.1[医药卫生—影像医学与核医学]