摘要
目的探讨经阴道超声对宫腔黏连患者宫腔容积和血流变化的临床评价及诊断价值。方法选取收治的宫腔粘连患者64例为研究组,同期来院体检的宫腔正常女性60例为对照组,2组均于月经周期中晚期行宫腔镜检查,记录2组子宫内膜厚度、宫腔形态、内部血流及回声情况,构建子宫内膜三维数据库,计算并比较2组宫腔容积、血管化血流指数(vascularization flow index,VFI)、血流指数(flow index,FI)、血管化指数(vascularization index,VI)。结果本研究宫腔粘连患者64例。其中Ⅰ型20例,影像学图像显示宫腔内少量粘连带;Ⅱ型30例,影像学图像显示宫腔内多处纤维状或膜状粘连;Ⅲ型8例,影像学图像显示宫腔狭小,宫腔广泛致密粘连;Ⅳ型2例,影像学图像显示为宫颈粘连;4例患者超声影像图未显示宫腔粘连。经阴道超声诊断患者宫腔粘连的准确率为93.75%。研究组子宫内膜厚度明显低于对照组,其子宫内膜厚薄不均一,回声不均一,三维宫腔形态不规则,内部血流信号稀少;对照组子宫内膜边界清晰,回声较均匀,三维宫腔形态规则,多呈三角形,内部血流信号丰富。研究组子宫容积、VFI、FI、VI明显低于对照组,差异均有统计学意义(P<0.05)。结论宫腔粘连患者的超声影像图显示为宫腔容积减小、血流变化参数降低,经阴道超声能够客观评价患者的宫腔容积和血流变化情况,对临床诊断具有参考价值,值得推广应用。
Objective To explore the clinical evaluation and diagnostic value of transvaginal sonography on uterine cavity volume,blood flow in patients with intrauterine adhesion.Methods A total of 64 cases of patients with gynecological uterine adhesion were selected as study group.And 60 cases normal female were selected as control group.They were examined by hysteroscopy during the middle and late menstrual cycle.The endometrial thickness,uterine cavity shape,internal flow and echo,3D build endometrial database, uterine volume,vascularization flow index（VFI）,flow index（FI）,vascularization index（VI）of two groups were compared.Results There were totally 64 cases with uterine cavity adhesion in this study,including 20 cases of type I,radiographic images showed intrauterine small adhesion;30cases of typeⅡ,radiographic image showed intrauterine more than fibrous or membrane adhesion;8cases of type Ⅲ,radiographic images showed the uterus was narrow,the uterus extensive dense adhesion;2 cases with type IV,radiographic image display for cervical adhesion;4 cases radiographic images not showed intrauterine adhesions. The accuracy of transvaginal ultrasonography in diagnosis of intrauterine adhesions was 93.75%.The endometrial thickness of study group was significantly lower than the control group.The endometrial thickness of study group was inhomogeneity,echo heterogeneity.The uterine cavity shape is irregular.The threedimensional uterine cavity is irregular and the internal blood flow signals are sparse.The endometrium of the control group was clearly defined,echo was uniform,the three-dimensional uterine cavity is regular in shape and triangular in shape,internal blood flow signals are abundant.The uterine volume,VFI,FI,VI of study group was significantly lower than the control group,the difference is statistically significant（P〈0.05）.Conclusion The ultrasonic image of the patient showed that the volume of the uterus decreased and the parameters of the blood flow decreased.Transvaginal ultrasound can objectively evaluate the uterine volume and blood flow changes,and provide a reference value for clinical diagnosis,which is worthy of popularization and application.
出处
《河北医科大学学报》
CAS
2017年第9期1072-1075,共4页
Journal of Hebei Medical University
基金
秦皇岛市科学技术研究与发展计划(201502A167)
关键词
宫腔粘连
超声检查
诊断
uterine diseases
ultrasonography
diagnosis
