腔内三维超声在宫腔粘连诊断中的价值

Value of transvaginal three-dimensional ultrasound in diagnosis of intrauterine adhesion

目的探讨腔内三维超声(3D-TVS)在宫腔粘连(IUA)诊断中的临床价值及应用。方法对2012-2013年苏州大学附属第一医院收治的204例患者分别行腔内二维超声(2D-TVS)及3D-TVS检查,分级诊断,与宫腔镜检查结果进行对比分析。结果 3D-TVS诊断的ROC曲线下面积为0.950,2D-TVS诊断的ROC曲线下面积为0.825。3D-TVS与宫腔镜的诊断结果进行一致性检验分析,轻、中、重度粘连的对应Kappa值分别为0.865、0.915、0.965。结论 IUA的超声分级与宫腔镜检查结果有较好的相关性,3D-TVS能够准确,直观,立体地显示IUA的空间位置,是一种更可靠的诊断IUA的影像学方法。

Objective To explore the clinical value and application of transvaginal three-dimensional ultrasound （3D-TVS） in di- agnosis of intrauterine adhesion. Methods A total of 204 patients treated in the hospital from 2012 to 2013 were examined by two-dimen- sional ultrasound （2D-TVS） and 3D-TVS, respectively, grading diagnosis was conducted, then the results were compared with the results of hysteroscopy. Results The areas under ROC diagnosed by 3D-TVS and 2D-TVS were 0. 950 and 0. 825, respectively. Kappa values of slight, moderate, and sever intrauterine adhesion in consistency test of hysteroscopy and 3 D-TVS were 0. 865, 0. 915, and 0. 965, respec- tively. Conclusion The correlation between ultrasonic diagnosis of intrauterine adhesion and hvsterosconic results is good, 3D-TVS can display three- dimensional spatial information of intrauterine adhesion accurately and directly, which is a more reliable imaging method for diagnosing intrauterine adhesion.