经阴道二维和三维超声对子宫腔内病变的不同诊断价值

Different diagnostic value of transvaginal two-dimensional and three-dimensional ultrasonography in intrauterine lesions

目的比较经阴道二维和三维超声对子宫腔内病变的诊断价值,为临床诊断提供参考。方法对2012年1月~2014年12月在我院诊断为宫腔内病变,后经病理证实的182例患者进行分组研究,选取术前进行经阴道三维超声检查的90例患者为观察组,选取同期术前进行经阴道二维超声检查的92例患者为对照组,对两组诊断的特异度、敏感度、准确度、阳性诊断率、阴性诊断率等进行比较。结果观察组通过三维超声检查在子宫内膜增生、子宫内膜息肉、子宫黏膜肌瘤诊断中的敏感度、特异度、准确度、阳性预测值、阴性预测值均高于对照组,差异有统计学意义(P<0.05);在对子宫内膜癌的诊断中,观察组的敏感度和准确度高于对照组,差异有统计学意义(P<0.05),但特异度、阳性预测值和阴性预测值比较,差异无统计学意义(P>0.05)。结论经阴道三维超声可显示冠状切面,对宫腔内疾病的检出率高于二维超声,有较高的临床价值。

Objective To compare the value of transvaginal two-dimensional and three-dimensional uhrasonography in the diagnosis of intrauterine lesions,to provide reference for clinical diagnosis.Methods Altogether 182 cases of pathologically confirmed patients who were diagnosed as intrauterine lesions from January 2012 to December 2014 in our hospital were divided into two groups,90 cases who accepted preoperative transvaginal three-dimensional ultrasound examinations were selected as the observation group,92 cases who accepted preoperative transvaginal two-dimensional ultrasound examinations at the same period of time were selected as the control group.The specificity,sensitivity,accura- cy,positive diagnosis rate and negative diagnostic rate of the two groups were compared.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the observation group in the diagnosis of endometrial hyperplasia and endometrial polyps,uterine fibroids mucosa by using three-dimensional ultrasound examinations was higher than those of the control group,with significant difference （P〈O.OS）.As for the diagnosis of endometrial cancer,the sensitivity and accuracy of the observation group was higher than those of the control group,with significant difference （P〈0,05）,there was no significant difference inthe the specificity,positive predictive value and negative predictive value between the two groups （P〉0.05）.Conclusion Transvaginal three--dimensional ultrasound can display coronal section with higher detection rate of intrauterine diseases than two-dimensional ultrasound,which has great clinical significance.