介入性超声与经阴道超声诊断宫腔粘连的价值

The Value of Interventional Ultrasound and Vaginal Ultrasound in Diagnosing Intrauterine Adhesions

目的探讨介入性超声与经阴道超声诊断宫腔粘连的价值。方法回顾性分析76例符合宫腔粘连临床表现的患者资料,比较经阴道超声与超声介入于宫腔镜联合对宫腔粘连的检出率,分析宫腔粘连的经阴道超声声像图、宫腔镜粘连程度分类,探讨介入性超声与经阴道超声对宫腔粘连的诊断价值。结果病理证实的宫腔粘连65例,经阴道超声检出率为80.00%,超声介入于宫腔镜检出率为98.46%,两种方法检出率比较有差异统计学意义(P<0.01);经阴道超声诊断的52例宫腔粘连超声声像图分型结果与宫腔镜检查粘连程度分类相比较有差异统计学意义(P<0.05),说明宫腔粘连的经阴道超声分型和宫腔镜检查粘连程度分类具有明显的相关性;经阴道超声检出的Ⅲ、Ⅳ型和宫腔镜检出的中度、重度粘连检出率均达100%,说明经阴道超声与宫腔镜对中度、重度粘连的患者有着相同的诊断价值。结论经阴道超声是宫腔粘连有效的诊断方法,可作为宫腔粘连的常规筛查;超声介入于宫腔镜检查诊断符合率高,是诊断宫腔粘连的金标准。

Objective To seek the value of intervention ultrasound and transvaginal ultrasound in diagnosing intrauterine adhesions. Methods A retrospective analysis from 76 patients who were accord with the clinical manifestations of intrauterine adhesions was adopted, comparing transvaginal ultrasound and ultrasound intervention hysteroscopy on the detection rate of intrauterine adhesions, the degree of intrauterine adhesions by transvaginal ultrasound Ultrasonographic and intervention hysteroscopy were analysed, and the value of ultrasound intervention of hysteroscopy and vaginal ultrasound on the diagnosis of intrauterine adhesions was explored. Results Pathology results confirmed 65 cases of intrauterine adhesions, of which transvaginal ultrasound detection rate was 80.00% while ultrasound intervention hysteroscopy 98.46 %, the detection rate of the two methods are of significant differences （ P 〈 0.01 ） ; 52 cases were diagnosed of intrauterine adhesions by transvaginal ultrasound,whose classification by transvaginal ultrasound and the adhesion level by hysteroscopy were significant different （ P 〈 0.05 ）, indicating that the transvaginal ultrasound type and the extent of adhesion degree by hysteroseopy in intrauterine adhesions has obvious relevance; the detection rate of Ⅲ, Ⅳ-type eases by transvaginal ultrasound and the detection rate of moderate and severe adhesions by Palace Endoscopic all reached 100 percent, showing that transvaginal ultrasound and hysteroseopy have the same value in diagnosing moderate and severe adhesions in patients. Conclusion transvaginal ultrasound is an effective diagnostic method in intrauterine adhesions; it can be used as a conventional screening of intrauterine adhesions; the accordance rate of interventional ultrasound hysteroscopy is of high rate in diagnosing intrauterine adhesions and it is the gold standard of which.