经阴道三维彩超在宫腔粘连筛查及治疗中的临床价值研究

Clinical value of transvaginal three-dimensional ultrasound for screening and treating intrauterine adhesion

目的探讨三维彩超应用于薄型子宫内膜患者宫腔粘连(IUA)筛查的优势。方法回顾性分析我院生殖门诊收治的、平素监测卵泡过程中提示子宫内膜薄的120例患者的临床资料,患者均进一步行经阴道三维彩超、宫腔镜检查,对检查结果进行数据分析,比较3种方法用于IUA筛查的准确性。结果120例子宫内膜薄的患者应用宫腔镜检查确诊IUA患者83例,二维彩超提示IUA的患者仅5例,三维彩超提示IUA的患者78例。三维彩超的确诊率为宫腔镜确诊率的93.98%。二维彩超对IUA的检出率(4.17%)显著低于三维彩超和宫腔镜检查(分别为65.00%和69.17%)(P<0.05)。且三维彩超对轻度IUA的检出率(85.19%)及中重度IUA的检出率(98.21%)均显著高于二维彩超(P<0.01),但其局限性在于不能明确分度。结论经阴道三维彩超成像能初步显示IUA的部位,可做为薄型子宫内膜患者IUA的初步筛查及术后评估手段。

To explore the clinical value of intrauterine adhesion(IUA)using transvaginal three-dimensional(3D)color ultrasound for screening and treating intrauterine adhesion.Methods:The data of120patients with thin endometrial found in the process of monitoring follicle by two-dimensional(2D)and had further examination by using transvaginal3D ultrasoundand or hysteroscopy were retrospectively analyzed.Results:Eighty three patients were diagnosed as IUA by hysteroscopy,only5patients were diagnosed as IUA by transvaginal2D color ultrasound,while78patients were diagnosed as IUA by transvaginal3D ultrasound in120patients with thin endometrium.The diagnosis rate of3D ultrasound was93.98%of hysteroscopy.The detection rate of IUA by2D ultrasound(4.17%)was significantly lower than that of3D ultrasound(65.00%)and hysteroscopy(69.17%)(P<0.05).The detection rate of mild IUA(85.19%)and moderate&severe IUA(98.21%)by3D ultrasound were significantly higher than2D ultrasound(P<0.01),but the limitation of3D ultrasound was that it cannot be clearly classified.Conclusions:Transvaginal three-dimensional color Doppler imaging can initially show the site of IUA.It can be used as a method to screen the intrauterine adhesion and postoperative assessment methods for patients with thin endometrium.