经腹、经阴道三维彩超及磁共振成像对深部浸润型子宫内膜异位症的诊断价值  

Diagnostic Value of Transabdominal and Transvaginal Three-dimensional Color Ultrasound and Magnetic Resonance Imaging in Deep Infiltrating Endometriosis

作　　者：吴开明 黄海虹 WU Kaiming;HUANG Haihong(The Second People's Hospital of Guigang,Guigang 537132,Guangxi Zhuang Autonomous Region,China;Gangnan District Maternal and Child Health Hospital,Guigang 537130,Guangxi Zhuang Autono-mous Region,China)

机构地区：[1]广西贵港市第二人民医院,广西贵港537132 [2]广西贵港市港南区妇幼保健院,广西贵港537130

出　　处：《世界复合医学(中英文)》2024年第12期183-186,198,共5页World Journal of Complex Medicine

摘　　要：目的探讨经腹、经阴道三维彩超及磁共振成像(magnetic resonance imaging,MRI)对深部浸润型子宫内膜异位症(deep infiltrating endometriosis,DIE)的诊断价值。方法选取2022年5月—2023年9月贵港市第二人民医院收治的70例疑似DIE患者,所有患者均行经腹三维彩超、经阴道三维彩超及MRI检查,并以腹腔镜手术病理检查为金标准,评估不同检查方法的诊断价值。结果70例疑似DIE患者中,经腹腔镜手术病理检查确诊阳性61例;其中病变累及直肠9例,直肠阴道隔8例,阴道壁8例,宫骶骨韧带13例,子宫直肠陷凹8例,膀胱6例,两种及以上9例;不同检查方法的灵敏度、准确度比较,差异均有统计学意义(P均<0.05)。经阴道三维彩超联合MRI检查DIE病症分布的诊断总符合率高于其他检查方式,但差异无统计学意义(P>0.05)。结论三维彩超诊断DIE方便快捷,但单一检查的临床诊断漏诊、误诊相对较高,MRI可弥补超声难以探及部位。临床需结合患者临床表征合理选择单一或联合的影像学检查,以减少漏诊误诊的出现。Objective To explore the diagnostic value of transabdominal and transvaginal three-dimensional ultrasound and magnetic resonance imaging(MRI)in deep infiltrating endometriosis(DIE).Meth-ods A total of 70 suspected DIE patients admitted to the Second People's Hospital of Guigang from May 2022 to September 2023 were selected.All patients underwent transabdominal three-dimensional color Doppler ultra-sound,transvaginal three-dimensional color Doppler ultrasound and magnetic MRI examination.Laparoscopic pathological examination was used as the gold standard to evaluate the diagnostic value of different examination methods.Results Among 70 suspected DIE patients,61 positive cases were confirmed by laparoscopiction and pathological examination.Among them,the lesions involved the rectum in 9 cases,the rectovaginal septum in 8 cases,the vaginal wall in 8 cases,the uterine and sacral ligaments in 13 cases,the uterine and rectal pits in 8 cases,the bladder in 6 cases,and two or more kinds of lesions in 9 cases.The sensitivity and accuracy of differ-ent examination methods were compared,and the differences were statistically significant(both P<0.05).The to-tal diagnostic coincidence rate of transvaginal three-dimensional color ultrasound combined with MRI was higher than that of other examination methods,but the difference was not statistically significant(P>0.05).Con-clusion Three-dimensional color ultrasound is convenient and fast in the clinical of DIE,but the clinical diag-nosis of single examination has relatively high misdiagnosis and missed diagnosis.MRI can compensate for the difficulty of ultrasound in detecting areas.Clinically,it is necessary to choose a single or combined imaging ex-amination based on the patient's clinical characteristics to reduce clinical misdiagnosis and missed diagnosis.

关 键 词：经腹三维彩超 经阴道三维彩超 深部浸润型子宫内膜异位症 

分 类 号：R445[医药卫生—影像医学与核医学]