经阴道超声检查在子宫内膜息肉样病变诊断中的价值

Study on the diagnostic value of transvaginal ultrasound in the diagnosis of endometrial polypoid lesions

目的 探讨经阴道超声检查在子宫内膜息肉样病变诊断中的价值.方法 选择2012年4月至2016年12月期间经我院临床初诊为子宫内膜息肉的患者344例为研究对象,所有对象术前均行彩色多普勒超声检查,分析其图像特征,以手术病理结果为金标准,分析超声诊断子宫内膜息肉样病变的特异性、敏感性和准确性.结果 本组344例患者术后病理诊断子宫内膜息肉142例,其中单纯子宫内膜息肉136例,子宫内膜息肉合并子宫内膜癌6例;经阴道超声检查诊断为子宫内膜息肉160例,误诊38例（11.05%,38/344）,漏诊20例（5.81%,20/344）,以术后病理结果为金标准,经阴道超声检查诊断子宫内膜息肉样病变的敏感性为85.92%（122/142）,特异性为81.19%（164/202）,准确性为73.14%（286/344）,超声诊断结果与病理诊断结果一致性良好（Kappa值〉0.75）.结论 经阴道超声检查的价值在于观察有无子宫息肉样病变,对病变的良恶性鉴别仍需行宫腔镜检查.

Objective To explore the diagnostic value of transvaginal ultrasound in endometrial polypoid lesions.Methods Three hundred and forty-four cases with endometrial polypoid lesions diagnosed in Hankou Hospital of Wuhan from April 2012 to December 2016 were selected as the research objects.All patients underwent color Doppler ultrasonography before surgery.The image features were analyzed,and the specificity, sensitivity and accuracy of ultrasound diagnosis of endometrial lesions were analyzed and pathological results served as the gold standard.Results According to the postoperative pathological diagnosis,142 cases were with endometrial polyps,Including 136 cases with simple endometrial polyps and 6 cases with endometrial polyps combined with endometrial carcinoma; 160 cases were diagnosed with endometrial polyps via transvaginal ultrasound,38 cases were misdiagnosed（11.05%,38/344）,20 cases were missed diagnosis（5.81%,20/344）, using the postoperative pathological results as the gold standard,the sensitivity of transvaginal ultrasonography in the diagnosis of endometrial lesions was 85.92%（122/142）,the specificity was 81.19%（164/202）,the accuracy was 73.14%（286/344）,and the diagnostic accuracy of ultrasonography was consistent with the pathological diagnosis（Kappa〉0.75）.Conclusion The value of transvaginal ultrasound is to observe the presence of uterine lesions, the identification of benign and malignant lesions still need hysteroscopy examination.