103例经阴道超声检查宫腔异常回声团的宫腔镜检查与病理结果分析

Analysis of hysteroscopy and histologic findings in 103 cases with uterine cavity abnormalities diagnosed by transvaginal sonography

目的:探讨经阴道超声检查(transvaginal sonography,TVS)对子宫内膜病变诊断的临床价值及宫腔异常回声团的成因。方法:对103例阴道超声提示“宫腔异常回声团”的患者行宫腔镜检查并取病理。结果:103例中子宫内膜息肉86例,息肉样腺肌瘤9例,子宫内膜单纯性增生2例,鳞状上皮1例,正常内膜3例,宫腔粘连1例,无组织刮出1例;TVS对子宫内膜病变检出的假阳性率3.88%,宫腔镜检查与病理诊断符合率84.47%。结论:TVS可作为子宫内膜病变的初筛手段,宫腔镜检查是确定病因的重要手段,但不能替代显微镜下的病理诊断。宫腔异常回声团多由子宫内膜息肉引起,常见于围绝经期及绝经后妇女。

Objective： To investigate the clinic value of transvaginal sonography （TVS） on diagnosing endometrial lesion and causes of uterine cavity abnormalities. Methods ： Hysteroscopy and hysteroscopic biopsy were performed on 103 women with uterine cavity abnormalities indicated by TVS. The results were compared with histologic findings. Results： 86 patients were diagnosed endometrial polyp, 9 patients were adenomyomatous polyp of endometrium , 2 patients were simple hyperplasia, 1 patient was squamous, 3 patients were normal endometrium, 1 patient was intrauterine adhesions, l patient was scanty material; TVS generates 3.88 percent （4/103） false positive results, compared with the pathologic diagnosis, the coincidence rate of diagnostic hysteroscopy was 84.47 %. Conclusion： For endometrial lesion, TVS is worthwhile as a screening tool, hysteroscopy is a essential tool for cause but can＇t instead pathologic diagnosis. Most of uterine cavity abnormalities were caused by endometrial polyp and existed in peirmenopausal period and postmenopausal women.