摘要
目的:探讨经阴道联合经腹部彩超在绝经后妇女子宫内膜良恶性病变诊断中的研究价值。方法:选择2020年3月—2021年2月郑州市妇幼保健院就诊的76例绝经后子宫内膜病变患者作为研究对象,均行经阴道彩超检查、经腹部彩超检查,以病理诊断结果为“金标准”,比较两种方法单项检查、联合检查对子宫内膜病变的检查结果及良恶性病变鉴别诊断效能。结果:病理诊断结果证实,76例患者中诊断为子宫内膜增生25例,子宫内膜息肉20例,子宫黏膜下肌瘤14例,萎缩性内膜10例,子宫内膜癌7例。以病理诊断结果为“金标准”,三种方法检出子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、萎缩性内膜、子宫内膜癌的符合率比较,差异有统计学意义(χ^(2)=11.562、5.625、7.636、10.646、6.353,P<0.05)。以病理诊断结果为“金标准”,三种方法的准确度、敏感度、特异度、阴性预测值、假阳性率、假阴性率、正确指数比较,差异有统计学意义(χ^(2)=50.593、65.094、50.399、109.365、65.094、49.562、165.745,P<0.05)。三种方法诊断绝经后子宫内膜病变的阳性预测值比较,差异无统计学意义(P>0.05)。经Kappa一致性检验分析,阴道超声与金标准结果之间的一致性Kappa值为0.261,腹部彩超与金标准结果之间的一致性Kappa值为0.018,经阴道联合经腹部彩超与金标准结果之间的一致性Kappa值为0.861,腹部彩超、阴道超声的一致性较差,经阴道联合经腹部彩超的一致性良好。结论:经阴道联合经腹部彩超在绝经后妇女子宫内膜良、恶性病变诊断中的效果良好,可提高诊断准确性,有利于为临床早期诊治绝经后子宫内膜病变提供指导依据。
Objective:To explore the application value of transvaginal combined with transabdominal color Doppler ultrasound in the diagnosis of benign and malignant endometrial lesions in postmenopausal women.Methods:76 patients with postmenopausal endometrial lesions who attended the hospital from March 2020 to February 2021 were selected for the study, all of whom underwent transvaginal ultrasonography and transabdominal ultrasonography. Pathologic findings were used as the“gold standard”, and the efficacy of the two methods was compared in terms of findings and differential diagnosis of benign and malignant lesions in endometrial lesions alone and in combination.Results:The pathological diagnosis confirmed that 25 cases of endometrial hyperplasia, 20 cases of endometrial polyps, 14 cases of submucosal fibroids, 10 cases of atrophic endometrium, and 7 cases of endometrial cancer were diagnosed in 76 patients. The pathological diagnostic results were used as the“gold standard”, and there was a statistically significant difference in the compliance rate of the three methods in detecting endometrial hyperplasia, endometrial polyps,submucosal fibroids, atrophic endometrium, and endometrial cancer(χ^(2)=11.562, 5.625, 7.636, 10.646, 6.353, P<0.05). Pathological diagnostic results were used as the“gold standard”, and the differences in accuracy, sensitivity, specificity, negative predictive value, false-positive rate, false-negative rate, and correct index of the three methods were statistically significant(χ^(2)=50.593,65.0941, 50.399, 109.365, 65.094, 49.562, 165.745, P<0.05). There was no statistically significant difference in the positive predictive value of the three methods for the diagnosis of postmenopausal endometrial lesions(P>0.05). Analysis by Kappa concordance test showed that the concordance Kappa value between vaginal ultrasound and gold standard results was 0.261, between abdominal ultrasound and gold standard results was 0.018, and between transvaginal combined with transabdominal ultrasound and gold standard results was 0.861. The concordance of abdominal ultrasound and vaginal ultrasound was poor, and the concordance of transvaginal combined with transabdominal ultrasound was good.Conclusion:Transvaginal combined with transabdominal ultrasound is effective in the diagnosis of benign and malignant endometrial lesions in postmenopausal women, which can improve the diagnostic accuracy and help provide guidance for the early diagnosis and treatment of postmenopausal endometrial lesions.
作者
李好平
LI Hao-ping(Department of Ultrasound,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou,Henan,450000,China)
出处
《黑龙江医学》
2023年第4期454-456,共3页
Heilongjiang Medical Journal
关键词
绝经后子宫内膜病变
阴道彩超
腹部彩超
良恶性病变鉴别诊断
Postmenopausal endometrial lesions
Vaginal color Doppler ultrasound
Abdominal color Doppler ultrasound
Differential diagnosis of benign and malignant lesions
