直肠超声内镜在直肠阴道膈子宫内膜异位症诊断中的应用

Application of Rectal Endoscopic Ultrasonography in Recto-vaginal Endometriosis Diagnosis

目的评价直肠超声内镜在直肠阴道膈子宫内膜异位症(RVEM)诊断中的应用价值。方法分析2009年9月至2016年9月在中国医科大学附属盛京医院妇科临床诊断为RVEM并接受手术治疗113例患者的临床资料,选取术前同时行直肠超声内镜、肠镜以及盆腔MRI检查的患者入组,共计36例,比较3种检查方法对RVEM是否侵袭肠壁、侵袭层次的术前诊断与术中所见和术后病理的符合度。结果直肠超声内镜对RVEM是否侵袭肠壁、侵袭层次的术前诊断准确率明显优于肠镜及盆腔MRI(P<0.05),与术中所见和术后病理符合度好。结论直肠超声内镜检查是诊断RVEM的可靠方法,可以在术前对RVEM患者是否伴有肠管受累以及受累程度进行准确诊断。

Objective To evaluate the diagnostic value of rectal endoscopic ultrasonography for recto-vaginal endometriosis （RVEM）. Methods The clinical data of 36 patients who met the criteria for RVEM between September 2009 and September 2016 in Shengjing Hospital were ana- lyzed. Rectal endoscopic ultrasonography was compared with colonoscopy and pelvic magnetic resonance imaging （MRI） in terms of preoperative diagnosis and their conformance with surgical and postoperative pathological findings. Results Rectal endoscopic ultrasonography was superior to colonoseopy and pelvic MRI in diagnosing RVEM, invasive bowel disease, and the invasive level in the preoperative assessment （P 〈 0.05 ）, and in its conformance with surgical and postoperative pathological findings. Conclusion Rectal endoscopic ultrasonography is a reliable technique for diagnosing RVEM, with good accuracy in the preoperative diagnosis of invasive bowel disease and its level of invasiveness.