宫腔声学造影对绝经后阴道出血子宫内膜病变的诊断价值

The value of hysterosalpingography in diagnosis of endometrial lesions in postmenopausal vaginal bleeding

目的:评价经宫腔声学造影对绝经后阴道出血子宫内膜病变的诊断价值。方法:对我院收治的98例绝经后阴道出血患者行阴道彩色多普勒超声检查和宫腔声学造影检查,在腹部超声的引导下对病变部位行钳夹、基地搔刮,清出组织行病理检查,并与宫腔声学造影诊断结果进行比较。结果:①98例宫腔声学造影均成功,其中经宫腔声学造影诊断为子宫内膜息肉46例,子宫肌瘤11例,子宫内膜癌4例,子宫内膜增生8例,子宫内膜无改变29例。②经组织病理学证实,经阴道彩超宫腔声学造影诊断的灵敏度为98%,特异度为88%,阳性预测值为94%,阴性预测值为97%。结论:经阴道彩超宫腔声学造影检查具有简便、无创、准确率高的特点,是子宫内膜病变筛查、诊断的首选、可靠方法,值得临床推广应用。

Objective：To evaluate the value of hysterosalpingography in diagnosis of endometrial lesions in postmenopausal vaginal bleeding.Methods：98cases of postmenopausal vaginal bleeding underwent transvaginal color Doppler ultrasound and hysterosonography imaging,abdominal ultrasound guided lesion clamp and base scraping,cleared tissue for pathological check.Results：①98cases of hysterosonography were successful,including 46cases of endometrial polyps,uterine fibroids in 11cases,4cases of endometrial cancer,endometrial hyperplasia in 8cases,no change of endometrial in 29cases.②By histopathological examination after the vaginal hysterosonography,it confirmed sensitivity 98%,specificity 88%,positive predictive value 94%,negative predictive value of 97%.Conclusion：Transvaginal color Doppler hysterosonography is a simple,non-invasive,high accuracy exam,it is the preferred and reliable method of screening and diagnosis of endometrial disease,is worthy of clinical application.