经阴道与经腹超声诊断子宫内膜异位症效果对比

Comparison of effects of transvaginal and transabdominal ultrasound in diagnosis of endometriosis

目的子宫内膜异位症是育龄期女性常见疾病,发病率较高,超声是目前临床上诊断子宫内膜异位症的常用方法。本研究分析阴道超声与经腹超声诊断子宫内膜异位症的效果,以寻求最佳的诊断方法。方法选取2017-03-01-2018-09-30郑州人民医院收治的74例疑为子宫内膜异位症患者作为研究对象,患者均行经腹超声及经阴道超声检查,将手术病理结果作为诊断金标准,对比经腹超声与经阴道超声的诊断价值。结果74例患者经手术病理诊断为子宫内膜异位症的有52例,其中卵巢子宫内膜异位囊肿37例,子宫腺肌症13例,盆腔内异位2例;经腹超声诊断准确率为78.38%,灵敏度为82.69%,特异度为68.18%,阳性预测值为86.00%,阴性预测值为60.00%;经阴道超声诊断准确率为91.89%,灵敏度为96.15%,特异度为81.82%,阳性预测值为92.59%,阴性预测值为90.00%;经阴道超声诊断准确率(χ^2=5.339,P=0.034)、灵敏度(χ^2=4.981,P=0.026)及阴性预测值(χ^2=5.114,P=0.024)较经腹超声高,差异均有统计学意义。结论经阴道超声诊断子宫内膜异位症可有效提升敏感度、准确率及阴性预测值。

OBJECTIVE Endometriosis is a common disease in women of childbearing age with a high incidence.Ultrasound is commonly used in clinical diagnosis of endometriosis.This study analyzed the effect of vaginal ultrasound and transabdominal ultrasound in the diagnosis of endometriosis,in order to find the best diagnostic method.METHODS A total of 74 patients suspected of endometriosis were selected from People′s Hospital of Zhengzhou from March 1,2017 to September 30,2018.All patients underwent transabdominal ultrasonography and transvaginal ultrasonography.The pathological results were used as the gold standard for diagnosis.The diagnostic value of transabdominal ultrasonography and transvaginal ultrasonography was compared.RESULTS Among 74 cases,52 cases of endometriosis were diagnosed by operative pathology,including 37 cases of ovarian endometriosis cyst,13 cases of adenomyosis,and 2 cases of pelvic ectopia.The diagnostic accuracy of transabdominal ultrasound was 78.38%,the sensitivity was 82.69%,the specificity was 68.18%,the positive predictive value was 86.00%,and the negative predictive value was 60.00%.The diagnostic accuracy of transvaginal ultrasound was 91.89%,the sensitivity was 96.15%,the specificity was 81.82%,the positive predictive value was 92.59%,the negative predictive value was 90.00%.The diagnostic accuracy,sensitivity and negative predictive value of transvaginal ultrasound were higher than those of transabdominal ultrasound,and the difference was statistically significant,χ^2 values were 5.339,4.981 and 5.114,Pvalues were 0.034,0.026 and 0.024,respectively.CONCLUSION Transvaginal ultrasound in diagnosis of endometriosis can increase sensitivity,accuracy and negative predictive value.