彩色多普勒超声检查对绝经后阴道出血临床诊断价值

Clinical Value of Color Doppler Ultrasonography in the Diagnosis of Postmenopausal Vaginal Bleeding

目的:评价彩色多普勒超声诊断绝经后阴道出血的效用,对比良恶性疾病的超声表现,总结超声诊断经验。方法:2016年10月-2017年12月,筛选符合条件绝经后阴道出血就诊的对象214例,最终诊断为恶性病变45例,均为子宫内膜癌,其余159例诊断为良性病变。结果:恶性组子宫内膜厚度、子宫动脉PS、宫腔容积高于良性组,差异有统计学意义(P<0.05)。四种方法灵敏度均在75%以下,腹部超声特异度相对较低。超声复查灵敏度、特异度、阳性预测值、阴性预测值、符合率均达到最高水平,分别为73.3%、96.2%、84.6%、92.7%、91.2%。结论:彩色多普勒超声可作为绝经后阴道出血病因的初步诊断方法,有较高的特异性,能够详细的评估子宫内膜形态、厚度辅助诊断,值得推广。

Objective： To evaluate the utility of color Doppler ultrasound in diagnosing postmenopausal vaginal bleeding, compare ultrasonic manifestations of benign and malignant diseases,and summarize the experience of ultrasound diagnosis. Methods： To select 214 patients of postmenopausal vaginal bleeding from October 2016 to December 2017, 45 cases were diagnosed as malignant lesions, all of them were endometrial cancer, and the remaining 159 cases were diagnosed as benign lesions. Results： The thickness of endometrium, the PS of uterine artery and the volume of uterine cavity were higher in the malignant group than in the benign group, and the difference was statistically significant（P〈0.05）. The sensitivity of the four methods was less than 75%, and the specificity of the abdominal ultrasound was relatively low. The sensitivity, specificity, positive predictive value, negative predictive value and coincidence rate of ultrasound examination reached the highest level, which were 73.3%, 96.2%, 84.6%, 92.7% and 91.2% respectively. Conclusion： Color Doppler ultrasound can be used as a preliminary diagnosis of causes of postmenopausal vaginal bleeding, has high specificity, to assess the endometrial morphology, thickness of diagnosis. It features high value.