摘要
目的探讨经阴道三维超声血流参数对宫腔黏连的临床诊断价值。方法选取2019年6月至2022年6月郑州大学附属郑州中心医院收治的108例疑似宫腔黏连患者作为研究对象。所有患者均行经阴道二维、三维超声检查,以宫腔镜检查结果作为“金标准”,比较两种诊断方法的诊断结果、诊断效能、诊断预测值;比较宫腔黏连和非宫腔黏连者经阴道三维超声血流参数[子宫内膜容积(EV)、血管指数(VI)、血流指数(FI)、血管化血流指数(VFI)];并对比不同宫腔黏连程度患者经阴道三维超声血流参数改变情况。结果108例疑似宫腔黏连患者中宫腔镜检查出76例阳性,32例阴性;经阴道二维超声检查出72例阳性,36例阴性;经阴道三维超声检查出75例阳性,33例阴性。经阴道三维超声诊断宫腔黏连灵敏度、特异度和准确度分别为96.05%、93.75%、95.37%,明显高于经阴道二维超声的82.89%、71.88%、79.63%,差异均有统计学意义(P<0.05);经阴道三维超声诊断阳性预测值和阴性预测值分别为97.33%、90.91%,明显高于经阴道二维超声的87.50%、63.89%,差异均有统计学意义(P<0.05);宫腔黏连者的EV、VI、FI、VFI参数明显低于非宫腔黏连者,重度宫腔黏连者的EV、VI、FI、VFI参数明显低于轻度和中度宫腔黏连者,差异均有统计学意义(P<0.05)。结论经阴道三维超声诊断宫腔黏连的效果较好,并能依据血流参数进一步评估病情严重程度。
Objective To observe the value of transvaginal threedimensional ultrasound blood flow parameters in the clinical diagnosis of uterine adhesions.Methods A total of 108 patients with suspected intrauterine adhesions admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2019 to June 2022 were selected as the study subjects.All patients underwent transvaginal 2D and 3D ultrasonography.The results of hysteroscopic examination were used as the"gold standard",and the diagnostic results,diagnostic efficiency,and diagnostic predictability of the two methods were compared.The transvaginal threedimensional ultrasound parameters(endometrial volume,EV;vascular index,VI;blood flow index,FI;vascularized blood flow index,VFI)were compared between patients with and without intrauterine adhesions.The changes in transvaginal threedimensional ultrasound parameters were compared among patients with different degrees of intrauterine adhesions.Results Out of 108 suspected patients with intrauterine adhesions,76 were positive and 32 were negative on hysteroscopy examination;72 were positive and 36 were negative on transvaginal twodimensional ultrasound examination;75 were positive and 33 were negative on transvaginal threedimensional ultrasound examination.The sensitivity,specificity,and accuracy of transvaginal threedimensional ultrasound in diagnosing intrauterine adhesions were 96.05%,93.75%,and 95.37%,respectively,which were significantly higher than 82.89%,71.88%,and 79.63%of transvaginal twodimensional ultrasound(P<0.05).The positive and negative predictive values of transvaginal threedimensional ultrasound for diagnosis were 97.33%and 90.91%,respectively,which were significantly higher than 87.50%and 63.89%of transvaginal twodimensional ultrasound(P<0.05).The EV,VI,FI,and VFI parameters of patients with intrauterine adhesions were significantly lower than those of patients without intrauterine adhesions,and the parameters of patients with severe intrauterine adhesions were significantly lower than those of patients with mild or moderate intrauterine adhesions,with statistically significant differences(P<0.05).Conclusion Transvaginal threedimensional ultrasound has a better diagnostic effect in the diagnosis of intrauterine adhesions,which can help further evaluate the severity of the disease based on the parameters of blood flow.
作者
谷小乐
张敬丽
张莹莹
栗浩然
GU Xiao-le;ZHANG Jing-li;ZHANG Ying-ying;LI Hao-ran(Department of Ultrasound Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Obstetrics and Gynaecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第18期2672-2675,共4页
Hainan Medical Journal
基金
河南省医学科技攻关计划联合共建项目(编号:LHGJ20210768)。
关键词
宫腔黏连
经阴道三维超声
血流参数
临床诊断
Intrauterine adhesion
Transvaginal three-dimensional ultrasound
Blood flow parameter
Clinical diagnosis
