3D/4D彩超在女性盆腔炎及盆底功能障碍性疾病中的诊断评价

Evaluation of the diagnostic effect of 3D /4D ultrasound on pelvic inflammatory disease and pelvic floor disorders

目的评价3D/4D彩超在女性盆腔炎(PID)及盆底功能障碍性疾病(PFD)中的诊断价值。方法随机选择在我院行健康体检和妇科等相关科室门诊收治的主诉PID或PFD相关症状的216例女性,检测其是否罹患PID(由2D和3D/4D彩超诊断)或PFD(由2D和3D/4D彩超以及核磁共振MR诊断),计算比较三种方式的诊断灵敏度和特异度,并用Logistic回归分析其影响因素。结果 2D和3D/4D彩超对PID的诊断灵敏度、特异度等指标无差异(P均>0.05);3D/4D彩超对PFD的诊断灵敏度(X^2=18.79,P<0.01)、阳性预测值(X^2=7.30,P=0.01)、阴性预测值(X^2=7.33,P=0.01)和诊断符合率(X^2=7.61,P=0.01)均显著高于2D彩超,但与MR比较无显著差异(P均>0.05);年龄≥55岁是影响2D彩超诊断效果的保护因素(P=0.043、OR=0.755、95%CI:0.351~3.074),而高级医师进行彩超检查诊断为影响3D/4D彩超诊断效果的保护因素(P=0.033、OR=0.450、95%CI:0.070~1.241)。结论 3D/4D彩超对女性PFD的诊断效果优于2D彩超,但与MR相当,两种彩超对PID的诊断效果无显著差异,临床对于PFD诊断应优先考虑使用3D/4D彩超,对PID可优先考虑2D彩超。

Objective To evaluate the diagnostic effect of 3D/4D ultrasound on pelvic inflammatory disease（ PID） and pelvic floor disorders（ PFD）. Methods 216 female individuals from physical examination or with PID or PFD symptoms were included,and then detected by 2D,3D /4D ultrasound and MR,following the sensitivity and specificity of these three methods were calculated and compared,finally,the influencing factors of these diagnostic effect were analyzed by Logistics regression. Results There was no significantly difference of the diagnostic effect of 2D and 3D /4D ultrasound on PID（ P〈0. 05）; the sensitivity（ χ^2= 18. 79,P〈0. 01）,positive predictive value（ χ^2= 7. 30,P = 0. 01）,negative predictive value（ χ^2= 7. 33,P = 0. 01）,and diagnostic accuracy（ χ^2= 7. 61,P = 0. 01） were significantly higher in 3D /4D ultrasound compared with 2D,bur similar to MR（ P〉0. 05）; Age≥55 years was protection factor for diagnosis effect of 2D ultrasound（ P = 0. 043,OR = 0. 755,95% CI：0. 351 - 3. 074）,while senior physician was protection factor for diagnosis effect of 3D /4D ultrasound（ P = 0. 033,OR =0. 450,95% CI： 0. 070 - 1. 241）. Conclusion 3D /4D ultrasound in the diagnosis of female PFD is better than 2D ultrasound and similar to MR,but the diagnosis of PID was no significant difference with 2D ultrasound,while in clinical diagnosis,PFD should give priority to the use of 3D /4D ultrasound.