经阴道三维超声成像对宫腔病变的诊断价值

Value of transvaginal three-dimensional ultrasonography in diagnosis of intrauterine lesions

目的探讨经阴道三维超声（3D-TVs）在宫腔病变诊断中的临床价值。方法对125例宫腔病变患者进行经阴道二维超声（2D-TVS）和3D-TVS检查，计算子宫内膜体积（EV），比较两种检查方法诊断宫腔病变与病理结果的符合率，并比较绝经后良恶性宫腔病变患者的EV值。结果3D-TVS诊断子宫内膜增生、子宫内膜息肉、黏膜下肌瘤、子宫内膜癌的符合率均高于2D-TVS，诊断宫腔病变的符合率也高于2D—TVS，差异均有统计学意义；绝经后子宫内膜癌患者EV值[（12．9±2．3）cm^3]高于宫腔良性病变患者[（9．8±2．7）cm^3]，差异有统计学意义。结论3D-TVS可获得宫腔病变冠状面图像，图像清晰显示病灶的形态、大小、回声及其与周围组织的关系，在宫腔病变诊断中具有重要价值，结合EV值的测定可提高对绝经后宫腔病变的良恶性鉴别能力。

Objective To investigate the clinical value of transvaginal three-dimensional ultrasonography （3D- TVS） in the diagnosis of intrauterine lesions. Methods Transvaginal ultrasound （TVS） and 3D-TVS were performed on 125 patients with uterine cavity lesions to calculate endometrial volume （EV）. Coincidence rates in the diagnosis of uterine cavity lesions for each of the two methods with pathological results were compared, and EV values of the postmenopausal women with benign and malignant uterine cavity lesions were compared. Results The coincidence rates of 3D-TVS in the diagnosis of endometrial hyperplasia, uterine endometrial polyps, submueosal myoma, and endometrial cancer were higher than those of 2D-TVS, and the coincidence rate in the diagnosis of uterine cavity lesions was higher than that of 2D-TVS. EV values of postmenopausal patients with endometrial cancer were higher than those of the patients with benign uterine cavity lesions [ （ 12.9 ± 2. 3） vs. （9. 8 ± 2.7） cm^3]. Conclusion 3D-TVS could obtain uterine cavity lesions coronal images and show the lesions in terms of shape, size, echo, and the relationship with the surrounding tissue. It has an important value in the diagnosis of uterine cavity lesions, and it can improve diagnostic capacity in differentiating benign and malignant lesions in postmenopausal women when combined with EV value determination.