宫腔粘连的阴道超声诊断及鉴别诊断

Transvaginal Ultrasound Diagnosis and Differential Diagnosis of In-trauterine Adhesions

目的探讨宫腔粘连的阴道超声表现以及鉴别诊断。方法通过回顾性总结2015年2月—2017年6月在该院被确诊为宫腔粘连患者80例阴道超声图像进行研究,根据宫腔粘连的分度,结合图像表现,对确诊、漏诊、误诊患者进行分析总结,提高诊断水平。结果轻度与中度宫腔粘连较为常见,粘连的具体位置不同其类型也并不相同,图像表达也存在差异,其主要是以混合表现为主,轻度与中度的子宫内膜厚度为3~13 mm,内膜形态的表现以条索状为主,低回声与高回声均会发生,重度粘连患者的粘连范围较为广泛,子宫内膜的厚度约为1~3 mm,形态表现主要是以线状为主。超声检查的准确率95.00%,漏诊率3.75%、误诊率1.25%,差异有统计学意义(P<0.05)。结论宫腔粘连的超声表现突出,能够完整的显示出患者的宫腔状况,临床诊断准确度较高,是一种早期、高效、可靠的诊断方式,可以为早期治疗提供可靠数据,值得临床推广。

Objective This paper tries to investigate the manifestation and differential diagnosis of intrauterine adhesions by vaginal ultrasound.Methods From February 2015 to June 2017,80 cases of intrauterine adhesions in this hospital were diagnosed as vaginal ultrasound images.According to the classification of intrauterine adhesions,combined with the imaging findings,the diagnosis,missed diagnosis,misdiagnosed patients were analyzed and the diagnostic level was improved.Results Mild and moderate intrauterine adhesions were more common,the specific location of adhesions of different types were not the same,there were differences in the expression of the image,mainly mixed performance,mild and moderate endometrial thickness of 3 to 13 mm,the performance of the endometrial structure of the cord-based,hypoechoic and hyperechoic would occur,severe adhesions in patients with a more extensive range of adhesions,the thickness of the endometrium was about 1 to 3 mm,the main morphological manifestations mainly linear.The accuracy of ultrasound examination of 95.00%,missed diagnosis rate of 3.75%,misdiagnosis rate of 1.25%,the data was statistically significant(P<0.05).Conclusion Ultrasonography of intrauterine adhesions with outstanding performance can fully show the status of uterine cavity in patients with high accuracy of clinical diagnosis,which is an early,efficient and reliable method of diagnosis,can provide reliable data for early treatment,so it is worth clinical promotion.