经腹、经阴道二维超声联合阴道三维超声诊断子宫内膜息肉的临床价值

Clinical value of transabdominal,transvaginal two-dimensional ultrasound combined with vaginal three-dimensional ultrasound in the diagnosis of endometrial polyps

目的探讨经腹、经阴道二维超声联合阴道三维超声诊断子宫内膜息肉的临床价值。方法选取2018年2月至2021年2月收治于赣州市妇幼保健院的120例疑似子宫内膜息肉患者作为研究对象。所有患者均行经腹部(2D-TAS)、经阴道二维超声(2D-TVS)及经阴道三维超声(3D-TVS)检查,以宫腔镜检查+病理活检结果为金标准,分析三种超声单独及联合检查的灵敏度、特异度、准确度。结果诊断结果显示,子宫内膜息肉患者102例。2D-TAS+2D-TVS+3D-TVS三者联合诊断子宫内膜息肉的检出率为97.50%,灵敏度为98.03%,特异度为94.44%,准确度为97.50%。三者联合诊断子宫内膜息肉的灵敏度、准确度、检出率均高于2D-TAS、2D-TVS、3D-TVS、2D-TAS+3D-TVS、2D-TVS+3D-TVS,差异有统计学意义(P<0.05);各种检查方式的特异度比较,差异无统计学意义(P>0.05)。结论经腹、经阴道二维超声联合阴道三维超声诊断子宫内膜息肉的准确度更高,可减少漏诊误诊,为临床治疗提供依据。

Objective To investigate the clinical value of transabdominal and transvaginal two-dimensional ultrasonography combined with vaginal three-dimensional ultrasonography in the diagnosis of endometrial polyps.Methods A total of 120 patients with suspected endometrial polyps admitted to Ganzhou Maternal and Child Health Hospital from February 2018 to February 2021 were selected as the research objects.All patients underwent transabdominal(2D-TAS),transvaginal two-dimensional ultrasound(2D-TVS)and transvaginal three-dimensional ultrasound(3D-TVS)examinations.The sensitivity,specificity and accuracy of the three ultrasound examinations alone and in combination were analyzed with the results of hysteroscopy and pathological biopsy as the gold standard.Results The diagnosis showed 102 patients with endometrial polyps.The detection rate of 2D-TAS+2D-TVS+3D-TVS in the combined diagnosis of endometrial polyps was 97.50%,the sensitivity was 98.03%,the specificity was 94.44%,and the accuracy was 97.50%.The sensitivity,accuracy and detection rate of combined diagnosis of endometrial polyps were higher than those of 2D-TAS,2D-TVS,3D-TVS,2D-TAS+3D-TVS,2D-TVS+3D-TVS,and the differences were statistically significant(P<0.05).There was no significant difference in the specificity of different examination methods(P>0.05).Conclusion The accuracy of transabdominal,trans vaginal two-dimensional ultrasound combined with vaginal three-dimensional ultrasound in the diagnosis of endometrial polyps is higher,which can reduce missed diagnosis and misdiagnosis,and provide a basis for clinical treatment.