经阴道三维超声成像对可疑子宫畸形患者诊断符合率的影响

Effect of Transvaginal Three-dimensional Ultrasonography on the Diagnostic Coincidence Rate of Patients with Sus-pected Uterine Malformation

目的:分析经阴道三维超声成像对可疑子宫畸形患者诊断符合率的影响,为临床干预提供指导性建议。方法:选取2018年12月—2020年6月周口市妇幼保健院可疑子宫畸形患者105例,均行阴道二维、三维超声成像检查,以宫腔镜检查结果为金标准,比较阴道二维及三维超声成像检查结果与宫腔镜检查结果及诊断效能(准确度、灵敏度、特异度、漏诊率、误诊率)、不同类型畸形符合率,并分析阴道三维超声成像声像图特征。结果:105例可疑子宫畸形患者经宫腔镜检查共检出畸形62例,非畸形43例;阴道二维超声检出畸形47例,非畸形58例;阴道三维超声成像检出畸形58例,非畸形47例;阴道三维超声成像诊断准确度、灵敏度高于阴道二维超声,漏诊率低于阴道二维超声,差异有统计学意义(χ^(2)=7.002,7.521,7.521,P<0.05);阴道三维超声成像诊断符合率93.55%(58/62)高于阴道二维超声75.81%(47/62),差异有统计学意义(χ^(2)=7.521,P<0.05)。结论:阴道三维超声成像诊断子宫畸形有较高价值,可明显提高诊断准确度、灵敏度,降低漏诊率,对不同畸形类型诊断有较高符合率,可为临床干预提供指导。

Objective:To analyze the effect of transvaginal three-dimensional ultrasound imaging on the diagnostic coincidence rate of patients with suspected uterine malformation, and to provide guidance for clinical intervention.Methods:A total of 105 patients with suspected uterine malformation from December 2018 to June 2020 in the hospital were selected, and all underwent vaginal two-dimensional and three-dimensional ultrasound imaging. The results of hysteroscopy were used as the gold standard, vaginal two-dimensional and three-dimensional ultrasound imaging results, hysteroscopy results and diagnostic performance (accuracy sensitivity, specificity, missed diagnosis rate, misdiagnosis rate), the coincidence rate of different types of deformities were compared, and vaginal three-dimensional ultrasound imaging sonographic features were analyzed.Results:Among the 105 patients with suspected uterine malformation, 62 malformations were detected by hysteroscopy, and 43 were non-deformities. Two-dimensional vaginal ultrasonography detected 47 deformities and 58 non-deformities. Three-dimensional vaginal ultrasound imaging detected 58 deformities and 47 non-deformities. The diagnostic accuracy and sensitivity of vaginal three-dimensional ultrasound imaging were higher than those of vaginal two-dimensional ultrasound, and the missed diagnosis rate was lower than that of vaginal two-dimensional ultrasound (χ^(2)=7.002, 7.521, 7.521, P<0.05). The diagnostic coincidence rate of vaginal three-dimensional ultrasound imaging was 93.55% (58/62), higher than 75.81% (47/62) of vaginal two-dimensional ultrasound (χ^(2)=7.521, P<0.05).Conclusion:Transvaginal three-dimensional ultrasound imaging has high value in the diagnosis of uterine malformations, which can significantly improve the diagnostic accuracy and sensitivity, reduce the missed diagnosis rate, and have a high coincidence rate for the diagnosis of different types of malformations, which can provide guidance for clinical intervention.