女性盆腔炎性疾病经直肠超声诊断技术研究

The research on transrectal ultrasonography in diagnosing female pelvic inflammatory diseases

目的:研究经直肠超声(TRS)技术在女性盆腔炎性疾病中的诊断价值,并与传统经腹超声(TAS)技术进行比较。方法:抽取64例临床诊断为盆腔炎性疾病的妇科患者,进行常规经腹超声检查。排空膀胱及排便后,采用阴式腔内探头再行经直肠超声检查。比较TRS、TAS两种技术在女性盆腔炎性疾病诊断中的显影清晰度及异常声像图诊出率的差异。结果:TRS技术在以子宫和卵巢为中心的近场图像的细微显影分辨能力,明显优于TAS技术(P<0.01)。与传统TAS技术相比,TRS技术可显著提高子宫内膜回声异常、输卵管增粗、子宫直肠窝积液/脓异常图像的诊出率(P值均小于0.05)。TRS对少量宫腔积液、少量子宫直肠窝积液/脓及输卵管增粗的捕获能力均优于TAS技术,但需排除高位远场异常。结论:TRS技术补充了传统的妇科超声诊断技术,其对盆腔炎性疾病的诊断能力优于TAS技术,可做为女性上生殖道炎性疾病的辅助诊断手段。

Objective： This study is to research the value of transrectal uhrasonography （TRS） in diagnosing female pelvic inflammatory diseases and to compare TRS technique with traditional transabdominal ultrasonography （TAS） technique. Methods： Sixty-four gynecological patients with clinical diagnosis of pelvic inflammatory diseases were selected. They received routine TAS exam followed by TRS exam with transvaginal intracavitary probe after urination and defecation. TRS technique was compared with TAS technique in diagnosing pelvic inflammatory diseases, in order to explore the differences of the two ultrasound techniques in visualization and diagnosis rates of abnormal sonogram. Results： The detail visualizing ability in near field （uterus/ovary-center） of TRS was better than TAS significantly （P〈0.01）. Compared with traditional TAS technique, TRS technique could increase visualization ratio of abnormal sonogram significantly such as abnormal echo of endometria, thickening of fallopian tube, fluid accumulation and pus in Douglas pouch（all P〈0.05）. The detecting ability of TRS was better than TAS for a small quantity of fluid in uterus and in Douglas pouch, fallopian tube thickening, but abnormalities in superior position and far field should be depleted. Conclusion： TRS was a supplement of uhrasonography technique in diagnosing gynecological diseases. It was better than TAS technique in diagnosing pelvic inflammatory diseases and could be used as auxiliary diagnostic method for female upper reproductive tract infections.