阴道超声和宫腔镜检查在绝经后子宫内膜病变中诊断价值

Transvaginal sonography and hysteroscopy in the diagnosis of postmenopausal endometrial diseases

目的:探讨阴道超声和宫腔镜检查诊断绝经后子宫内膜病变的临床价值。方法:160例绝经后子宫内膜病变患者行阴道超声及宫腔镜检查;以病理结果为标准,评价阴道超声和宫腔镜检查对诊断子宫内膜病变的敏感性、特异性、阳性预测值及阴性预测值。结果:经阴道超声检查48例正常,其中40例病理证实子宫内膜无异常;112例诊断为宫腔病变,其中96例经病理证实。宫腔镜检查52例正常,其中1例病理证实为子宫内膜单纯型增生;108例诊断为宫腔病变,其中103例经病理证实。宫腔镜检查宫腔内病变、子宫内膜癌和癌前病变的特异性、阳性预测值均高于经阴道超声检查(P<0.05).结论:经阴道超声检查是一种筛查子宫内膜病变较好的方法;阴道超声联合宫腔镜检查对诊断绝经后子宫内膜病变有重要价值。

Objective To study the clinical value of transvaginal sonography and hysteroscopy to the diagnosis of postmenopausal endometrial diseases.Methods The data of 160 patients received transvaginal sonography inspection and transvaginal sonography inspection.The sensitivity,specificity,positive predictive value and negative predictive value of transvaginal sonography and hysteroscopy were evaluated and compared based on the histopathologic results.Results In 48 cases of normal endometrium proved by transvaginal sonography,40 cases（83.33%） were pathologically proved normal endometrium.In 112 cases of intracavitary diaseases diagnosed by transvagina sonography,96 cases（85.71%） were pathologically proved.In 52 cases of normal endometrium by hysteroscopy,one case was pathogically proved endometrial hyperplasia.In 108 cases of intracavitary diseases diagnosed by hysteroscopy,103 cases（95.4%） were pathologically proved.The specificity and positive predictive value of hysteroscopy were higher than those of transvaginal sonography in the detection of intracavitary diseases,endometrial carcinoma and precancerosis（P〈0.05）.Conclusion Transvaginal sonography is a very good method for screening endometrial diseases.The combination of transvaginal sonography and hysteroscopy is of great value to the diagnosis of postmenopausal endometrial diseases.