腹部超声与阴道超声诊断子宫腺肌病的对比分析

Abdominal ultrasound versus transvaginal ultrasound in the diagnosis of uterine adenomyosis

目的探讨腹部超声与阴道超声对子宫腺肌病的诊断价值比较。方法回顾性分析120例经阴道和经腹部彩色多普勒超声提示为子宫腺肌病患者的影像学资料，观察经腹部超声和经阴道超声的诊断结果，术后取病变组织进行活检，以最终病理检查结果作为金标准，与金标准进行对照。结果本研究共经病理诊断确诊子宫腺肌病98例，子宫粘膜下肌瘤17例，巧克力囊肿3例，正常2例。经阴道彩超组和经腹部彩超组其灵敏度分别为91．84％、73．47％；特异性分别为86．36％、68．18％；阳性预测值分别为96．77％、91．14％；阴性预测值分别为70．37％、36．59％；诊断符合率分别为90．83％、72．50％；经阴道彩超检查结果明显优于对照组（P〈0．05）。结论经阴道彩超灵敏度、特异性、超声诊断符合率等均显著优于经腹部彩超，两者结合更能提高子宫腺肌病的准确率。

Objective To investigate the value of abdominal ultrasound versus that of transvaginal ultrasound for the diagnosis of adenomyosis. Methods The imaging data on 120 patients with adenomyosis diagnosed by transvaginal and abdominal color Doppler ultrasound were retrospectively analyzed. The findings of the two different procedures were observed. The pathological tissues were biopsied after the procedures. The results of pathological examination were used as gold standard; and the findings of ultra- sound were compared with s the gold standard. Results In this study, adenomyosis was pathologically confirmed in 98 patients, uterine submucosal myoma in 17 patients, and chocolate cyst in 3 patients. The sensitivity was 91.84% for transvaginal ultrasonography and 73.47% for abdominal uhrasonography; the specificity was 86.36% and 68.18%; the positive predictive values were 96.77% and 91.14%; and the negative predictive values were 70.37% and 36.59%, respectively. Transvaginal ultrasound was superior to abdominal ultrasound in the diagnostic accordance rate （ 90.83% vs. 72.50%, P 〈 0.05 ）. Conclusions Transvaginal color Doppler is significantly superior to abdominal ultrasonography in sensitivity, specificity, and diagnostic accordance rate. A combination of both procedures can enhance the diagnostic accuracy of adenomyosis.