经阴道三维超声宫腔造影对子宫内膜息肉的诊断价值

Diagnostic value of three dimensional saline-infused sonohysterography in uterine endometrial polyps

目的评价经阴道超声(TVS)、三维超声宫腔声学造影(3D-SIS)及宫腔镜(HS)检查对子宫内膜息肉的诊断价值。方法选择2013年11月至2014年11月间就诊于山西医学科学院山西大医院临床疑诊为子宫内膜息肉患者80例,行2D-TVS同时行3D-SIS检查,所有患者均行宫腔镜检查或手术并送病理组织学检查,计算两种方法诊断子宫腔内病变的敏感度、特异度、阳性预测值、阴性预测值及诊断准确率。结果 TVS诊断子宫内膜息肉的敏感性、特异度、准确性、阳性预测值、阴性预测值分别为75.00%、33.33%、62.50%、75.00%、33.33%;3D-SIS诊断子宫内膜息肉的敏感性、特异度、准确性、阳性预测值、阴性预测值分别为93.33%、80.00%、90.00%、93.33%、80.00%;宫腔镜诊断子宫内膜息肉的敏感度、特异度、准确性、阳性预测值、阴性预测值分别为96.15%、92.86%、95.00%、96.15%、92.86%。结论 3D-SIS图像为临床医师提供更多信息,有助于指导临床医师手术前的准备,在临床实际工作中有一定的应用价值。

Objective To evaluate the diagnostic value of transvaginal ultrasonography（TVS）, three dimensional saline-infused sonohysterography（3 D-SIS）, and hysteroscopy（HS） in patients with endometrial polyps of the uterus. Methods Eighty patients with clinically suspected endometrial polyps were randomly divided into two groups to undergo 2 D-TVS and 3 D-SIS, respectively. All patients underwent pathologic examination after HS or surgical therapy. Using pathological results as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of each method were calculated. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 2 D-TVS were 75.00%, 33.33%, 62.50%, 75.00%, and 33.33%, respectively; the corresponding values were 93.33%, 80.00%, 90.00%, 93.33%, and 80.00% for 3 D-SIS, and 96.15%, 92.86%, 95.00%, 96.15%, and 92.86% for HS. Conclusion 3 D-SIS can provide much more detailed information on uterine endometrial polyps and guide clinicians to make decisions before surgery.