经阴道二维联合三维超声Omniview技术在Ⅱ型黏膜下子宫肌瘤术前诊断中的价值

Application value of 2D-TVS combined with 3D-TVS with Omniview technique in the preoperative diagnosis of type Ⅱ submucosal hysteromyoma

目的:探讨经阴道二维(2D-TVS)联合三维超声(3D-TVS)Omniview技术在Ⅱ型黏膜下子宫肌瘤术前诊断中的应用价值。方法:回顾2019年7月—2021年12月在徐州市妇幼保健院常规妇科超声检查发现可疑黏膜下子宫肌瘤78例患者,经3D-TVS进一步检查,入院后经宫腔镜(HS)手术诊断70例,术后病理证实72例,分析78例患者图像及检查报告,将检查结果与手术分型结果进行比较,分析其诊断敏感度。结果:2D-TVS和3D-TVS对0型和Ⅰ型黏膜下子宫肌瘤的诊断敏感度均较高,差异没有统计学意义。对Ⅱ型黏膜下子宫肌瘤,2D-TVS诊断符合率仅为69.2%,而3D-TVS诊断符合率92.3%,两种检查方法比较差异有统计学意义(P<0.05)。结论:经2D-TVS结合3D-TVS对黏膜下子宫肌瘤术前分型结果与手术病理结果诊断符合率高达94.4%。经2D-TVS结合3D-TVS操作简便、经济、无创,可重复性强等优点,可作为临床术前诊断黏膜下子宫肌瘤的首选方法,具有良好的经济效益及社会效益。

Objective:To explore the application value of two-dimensional transvaginal sonography(2D-TVS)combined with three-dimensional transvaginal sonography(3D-TVS)Omniview technique in the preoperative diagnosis of typeⅡsubmucosal hysteromyoma.Methods:From July 2019 to December 2021,78 patients with submucosal hysteromyoma were identified by routine gynecological ultrasound in Xuzhou Maternity and Child Healthcare Hospital.Seventy-two cases were further diagnosed by 3D-TVS,and 70 cases were confirmed by hysteroscopy.The classification results of imaging were compared with the classification results of surgery,and the diagnostic coincidence rate was analyzed.Results:The sensitivity of 2D-TVS and 3DTVS with omniview technique in the diagnosis of type 0 and typeⅠsubmucosal hysteromyoma was high.There was no statistical significance(P>0.05).For typeⅡsubmucosal hysteromyoma,the diagnostic coincidence rate of 2D-TVS was only69.2%,while that of 3D-TVS with omniview technique was 92.3%.There was significant difference between the two techniques(P<0.05).Conclusion:The diagnostic coincidence rate of 2D-TVS combined with 3D-TVS with omniview technique and surgical pathology was as high as 94.4%in preoperative classification of submucosal hysteromyoma.2D-TVS combined with3D-TVS with ommiview technique has the advantages of simple operation,economy,noninvasive and repeatible,which can be used as the first choice for clinical preoperative diagnosis of submucosal hysteromyoma.