摘要
目的:分析经阴道三维超声鉴别诊断子宫内膜病变类型及子宫内膜癌分期的价值。方法:选取医院收治的因疑似子宫内膜病变的186例患者,均行阴道三维超声检查,其结果显示异常者行宫腔镜检查,以术后病理诊断结果为参照,比较阴道三维超声和宫腔镜对不同子宫内膜病变诊断符合率、灵敏度、特异度、阳性预测值、阴性预测值及对子宫内膜癌分期的诊断符合率。结果:在186例患者中病理诊断子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、子宫内膜炎、子宫内膜癌和正常者分别为69例、44例、30例、2例、21例和20例,阴道三维超声的诊断符合率分别为86.96%(60/69)、72.73%(32/44)、60.00%(18/30)、100.00%(2/2)和71.43%(15/21)。阴道三维超声与宫腔镜在诊断子宫内膜息肉、黏膜下肌瘤和内膜癌的符合率比较,差异有统计学意义(x^(2)=5.709,x^(2)=18.178,x^(2)=11.769;P<0.05)。阴道三维超声对子宫内膜癌Ⅰa期、Ⅰb期诊断符合率明显低于病理结果,差异有统计学意义(x^(2)=100.008,x^(2)=100.008;P<0.05)。阴道三维超声与宫腔镜诊断子宫内膜病变的效能中,两种检查方法的特异度和阴性预测值比较,差异具有统计学意义(x^(2)=9.524,x^(2)=57.483;P<0.05)。结论:经阴道三维超声可准确鉴别诊断子宫内膜病变,可对子宫内膜癌做出诊断及术前分期,并可为临床选择恰当治疗方案提供有效依据。
Objective:To analyze the value of transvaginal three-dimensional(3D)ultrasound in differential diagnosis for the type of endometrial lesions and the staging of endometrial carcinoma.Methods:186 patients with suspected endometrial lesions who admitted to hospital were examined by 3D ultrasound on vagina.Those with abnormal results were further examined by hysteroscopy.The results of postoperatively pathological diagnosis were used as references to compare the diagnostic accordance rate,sensitivity,specificity,positive predictive value and negative predictive value of endometrial lesion,and the diagnostic accordance rate of the staging of endometrial carcinoma between 3D ultrasound on vagina and hysteroscopy.Results:In 186 patients,the results of pathological diagnosis indicated that 69 cases were endometrial hyperplasia,and 44 cases were endometrial polyps,and 30 cases were submucosal myoma of uterus,and 2 cases were endometritis,and 21 cases were endometrial carcinoma and 20 cases were normal,respectively.The diagnostic accordance rates of transvaginal 3D ultrasound with pathological diagnosis were 86.96%(60/69),72.73%(32/44),60.00%(18/30),100.00%(2/2)and 71.43%(15/21),respectively.The differences of diagnostic accordance rates in the diagnoses of endometrial polyps,submucosal myoma of uterus and endometrial carcinoma between transvaginal 3D ultrasound and hysteroscopy were statistically significant(x^(2)=5.709,x^(2)=18.178,x^(2)=11.769,P<0.05).The diagnostic accordance rates of transvaginal 3D ultrasound in the diagnoses of stage Ia and stage Ib of endometrial carcinoma were significantly lower than those of pathological results,and the differences of those between two methods were statistically significant(x^(2)=100.008,x^(2)=100.008,P<0.05).In the efficacies of transvaginal 3D ultrasound and hysteroscopy in the diagnoses of endometrial lesions,there was significant differences in the specificity and negative predictive value between the two methods(x^(2)=9.524,x^(2)=57.483,P<0.05).Conclusion:Transvaginal 3D ultrasound can accurately distinguish and diagnose endometrial lesions,and can make diagnosis and preoperative staging for endometrial carcinoma,and can provide effective reference for appropriately therapeutic schedule in clinical selection.
作者
陈慧敏
周涵
钟玲
毛晓丽
王文
吕洪财
CHEN Hui-min;ZHOU Han;ZHONG Ling(Department of Function,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 443000,China;不详)
出处
《中国医学装备》
2021年第10期83-87,共5页
China Medical Equipment
基金
湖北省健康管理委员会科研项目(WJ2019F163)“经阴道彩色多普勒超声在不同子宫内膜癌分期中的诊断价值”。
关键词
阴道三维超声
宫腔镜
子宫内膜病变
子宫内膜癌
Three-dimensional(3D)ultrasound on vagina
Hysteroscopy
Endometrial lesions
Endometrial carcinoma
