摘要
目的探讨经阴道三维超声(transvaginal three-dimensional ultrasound,3D-TVS)在宫腔粘连(intrauterine adhesion,IUA)患者诊断中的应用价值。方法选取2020年1月至2022年11月景德镇市第二人民医院经X线诊断为IUA的80例患者作为研究对象,分别行3D-TVS检查和二维超声检查。以宫腔镜诊断为金标准,比较3D-TVS检查和二维超声检查对IUA程度(轻度、中度、中度)和分型(中央型、周围型、混合型)的检出率及漏诊率,比较不同程度IUA患者的血流参数,分析3D-TVS检查、二维超声检查及联合检查对IUA的诊断效能。结果3DTVS检查对不同程度及不同分型IUA的检出率均高于二维超声检查,漏诊率低于二维超声,差异有统计学意义(P<0.05)。轻度、中度、重度患者子宫内膜容积(endometrial volume,EV)、血流指数(flow index,FI)、内膜区血管指数(vascular index,VI)、血管血流指数(vascular flow index,VFI)比较差异有统计学意义(P<0.05);轻度患者EV大于中度、重度患者,FI、VI、VFI均高于中度、重度患者,且中度患者EV大于重度患者,FI、VI、VFI均高于重度患者,差异有统计学意义(P<0.05)。3D-TVS检查与联合检查诊断的灵敏度与准确度均高于二维超声检查,差异有统计学意义(P<0.017)。结论3D-TVS检查对IUA患者的诊断效能较高,能较为精准区分患者IUA程度和分型,值得临床推广应用。
Objective To investigate the application value of transvaginal three-dimensional ultrasonography in diagnosis of intrauterine adhesions(IUA).Methods 80 patients diagnosed with IUA by X-ray in the Second People's Hospital of Jingdezhen from January 2020 to November 2022 were selected as the study subjects,and they were underwent 3D-TVS examination and 2D ultrasonography examination,respectively.Took the hysteroscopy as the gold standard,the detection and underdiagnosis rates of the IUA degree(mild,moderate,intermediate)and staging(central,peripheral,mixed)of IUA were compared between 3D-TVS examination and 2D ultrasonography examination,and blood flow parameters of patients with different degrees of IUA were compared,the diagnostic efficiency of 3D-TVS examination,2D ultrasonography examination and combined detection examination of IUA was analyzed.Results The detection rate of different degrees and types of IUA by 3D-TVS examination were higher than thoes of 2D ultrasonography examination,and the underdiagnosis rate was lower than that of 2D ultrasonography examination,the differences were statistically significant(P<0.05).There were significant differences in endometrial volume(EV),flow index(FI),vascular index(VI)and vascular flow index(VFI)among mild,moderate and severe patients(P<0.05);the EV of mild patients was greater than that of moderate and severe patients,and the FI,VI and VFI were higher than those of moderate and severe patients,and the EV of moderate patients was greater than that of severe patients,and the FI,VI and VFI were higher than those of severe patients,the differences were statistically significant(P<0.05).The sensitivity and accuracy of diagnosis of 3D-TVS examination and combined examination were higher than those of 2D ultrasonography examination,the differences were statistically significant(P<0.05).Conclusion 3D-TVS examination has high diagnostic efficacy for IUA patients,and can accurately distinguish the degree and staging of IUA,which is worthy of clinical promotion and application.
作者
程云
余洁
余娟
CHENG Yun;YU Jie;YU Juan(Department of Ultrasound,the Second People's Hospital of Jingdezhen,Jingdezhen,Jiangxi,333000,China)
出处
《当代医学》
2024年第36期59-63,共5页
Contemporary Medicine
关键词
宫腔粘连
经阴道三维超声
诊断
漏诊
分型
粘连程度
Intrauterine adhesions
Transvaginal three-dimensional ultrasonography
Diagnosis
Missed diagnosis
Typing
Adhesion degree
