三维超声与二维超声对阴道壁囊肿的诊断价值探讨

The value of three-dimensional ultrasound and two-dimensional ultrasound in the diagnosis of vaginal cyst

目的:探讨对阴道壁囊肿患者采用阴式三维彩超与二维超声检查诊断的临床价值。方法:对经临床表现怀疑为阴道壁囊肿的173例妇女采用二维超声与三维彩超检查,以妇科手术结果及阴道镜检查作为金标准判定二维超声与三维超声诊断的临床价值。结果:阴式三维彩超共发现39个阴道囊肿病灶,二维超声发现30个阴道囊肿病灶,手术及阴道镜检查发现42个阴道囊肿病灶,大小范围0.4cm×0.3cm^1.4cm×0.9cm;阴式三维彩色超声发现阴道壁检测囊肿正确率为92.86%,显著高于二维超声的71.43%(χ2=6.574,P=0.010)。阴式三维彩色超声检查结果与手术或阴道镜证实结果的一致性:Kappa为0.887,P=0.000<0.05;灵敏度为88.10%,特异度为98.47%,误诊率为1.53%,漏诊率为11.90%。二维超声检查结果与手术或阴道镜证实结果的一致性:Kappa为0.652,P=0.000<0.05;灵敏度为61.90%,特异度为96.95%,误诊率为3.05%,漏诊率为38.10%。阴式三维彩超检测阴道壁囊肿的ROC下曲线面积为AZ=0.892,二维超声检测阴道壁囊肿的ROC下曲线面积为AZ=0.785。结论:阴道壁囊肿患者采用阴式三维彩超检测的准确性高于二维超声,对于临床检查的价值更高。

Objectives： To investigate the clinical value of using transvaginal three - dimensional color doppler and two -dimensional ultrasonography in the diagnosis of vaginal Cyst. Methods： 173 women suspected of va- ginal cyst were examined by two - dimensional ultrasound and three - dimensional color doppler ultrasound examina- tion. Results of gynecological operation and colposcopy were used as the gold standards to determine the clinical value of two- dimensional ultrasound and three -dimensional ultrasound diagnosis. Results： Transvaginal three -dimen- sional color doppler found vaginal cyst in 39 patients, and two - dimensional ultrasound found 30 vaginal hydatid cyst, while surgery and colposcopy found 42 vaginal cyst, size ranging 0.4cm×0.3cm ×1.4cm× 0.9cm. The detection rate of transvaginal three - dimensional color doppler was 92.86%, which was significantly higher than two - dimensional ultrasound of 71.43% （X^2 = 6.574, P = 0.010）. The consistency of transvaginal three - dimensional color doppler ul- trasound examination and the results of surgery or eolpescopy results ： kappa was 0. 887, P = 0. 000 〈 0. 05 ; the sensi- tivity was 88.10% ; the specificity was 98.47% ; misdiagnosis rate was 1.53% ; and the rate of missed diagnosis was 11.90%. The consistency of two - dimensional ultrasunography and surgical findings or colposcopy results： kappa was 0.652, P = 0.000 〈 0. 05 ; the sensitivity was 61.90% ; the specificity was 96.95% ; misdiagnosis rate was 3.05% ; and the rate of missed diagnosis was 38.10%. The ROC areas of vaginal cyst detected by three - dimensional trans- vaginal color doppler ultrasound and two - dimensional ultrasonography were 0. 892 and 0. 785 respectively. Conclusions： The detection accuracy of vaginal cyst by transvaginal three -dimensional ultrasonography is higher thanthat of two - dimensional ultrasound, which is of higher value in clinical examination.