宫腔镜与阴道超声检查子宫腔内病变临床价值探讨

Diagnosis value of hysteroscopy and transvaginal sonography in intrauterine cavity lesions

目的对比宫腔镜检查(HS)与阴道超声检查(TVS)诊断子宫腔内病变的价值。方法对235例患者同时采用HS和TVS,并与最后的病理结果对照。结果HS对子宫内膜息肉和子宫内膜增生的敏感性和特异性分别是94.37%、81.7%和90.74%、98%;均高于TVS的71.2%、63%和77.2%、94%。TVS对子宫内膜癌诊断的敏感性是100%,高于HS的敏感性84.62%,但其特异性仅为66.67%,低于HS的敏感性91.67%。结论HS结合直视下活检是宫内疾病诊断的金标准。而TVS因其无创、低价、重复性好,可作为初筛方法。

Objective To explore the value of hysteroscopy （HS） and transvaginal sonography （TVS） in the diagnosis of intrauterine cavity lesions. Methods 235 intrauterine cavity lesion cases were detected by HS and TVS at the same time, and the results were compared with pathologic findings. Results The sensitivity and specificity to endometrial hyperplasia and endometrial polyps were higher by HS than TVS. The sensitivity to endometrial cancer was higher by TVS than HS, but the specificity was lower. Conclusion HS with biopsy is the gold diagnosis standard for the intrauterine cavity lesions. TVS, being noninvasive, inexpensive, and having a good repeatability, is still irreplaceable and should be preferably used as a preliminary screening measure.