超声诊断子宫内膜异位症的临床应用价值分析

Analysis of the clinical application value of ultrasonography in the diagnosis of endometriosis

目的探讨超声诊断子宫内膜异位症的临床应用价值。方法90例疑似子宫内膜异位症患者为研究对象,应用彩色多普勒超声仪为患者进行经阴道及经腹部超声检查。观察经阴道超声及经腹部超声的诊断结果及影像学特征,以病理诊断结果为金标准,比较两种检查方式的诊断效能与肿块诊断符合率。结果90例患者中,病理确诊子宫内膜异位症阳性84例,占比为93.33%。经阴道超声诊断子宫内膜异位症阳性83例,阳性率为98.81%;经腹部超声诊断子宫内膜异位症阳性65例,阳性率为77.38%。经阴道超声诊断子宫内膜异位症的阳性率高于经腹部超声,差异有统计学意义(P<0.05)。经阴道超声诊断子宫内膜异位症的准确率96.67%、特异度83.33%、灵敏度97.62%、阳性预测值98.80%、阴性预测值71.43%、误诊率16.67%、漏诊率2.38%均优于经腹部超声的67.78%、16.67%、71.43%、92.31%、4.00%、83.33%、28.57%,差异有统计学意义(P<0.05)。84例患者病理诊断显示实性肿块40例、囊性肿块20例、囊实性肿块24例。经阴道超声对实性肿块、囊性肿块、囊实性肿块诊断符合率分别为95.00%、100.00%、100.00%,均高于经腹部超声的70.00%、60.00%、83.33%,差异有统计学意义(P<0.05)。结论经阴道超声可有效提升子宫内膜异位症检查有效性,具备重要参考价值,能够有效提升疾病诊断符合率,降低误诊率,值得在临床中推广及应用。

Objective To discuss the clinical application value of ultrasonography in the diagnosis of endometriosis.Methods 90 patients with suspected endometriosis were selected as the research subjects,and color Doppler ultrasonography was used for transvaginal and transabdominal ultrasonography.The diagnostic results and imaging features of transvaginal ultrasonography and transabdominal ultrasonography were observed,and the diagnostic efficacy and diagnostic accordance rare of the mass of the two examination methods were compared using pathological results as the gold standard.Results Among the 90 patients,pathology confirmed positive endometriosis in 84 cases,accounting for 93.33%.There were 83 cases of endometriosis diagnosed by transvaginal ultrasonography,with a positive rate of 98.81%;65 cases of endometriosis diagnosed by transabdominal ultrasonography,with a positive rate of 77.38%.The positive coincidence rate of transvaginal ultrasonography in the diagnosis of endometriosis was higher than that of transabdominal ultrasonography,and the difference was statistically significant(P<0.05).The accuracy of transvaginal ultrasonography for the diagnosis of endometriosis was 96.67%,the specificity was 83.33%,the sensitivity was 97.62%,the positive predictive value was 98.80%,the negative predictive value was 71.43%,the misdiagnosis rate was 16.67%,and the missed diagnosis rate was 2.38%,which were better than 67.78%,16.67%,71.43%,92.31%,4.00%,83.33%,28.57%of transabdominal ultrasonography,and the differences were all statistically significant(P<0.05).Pathological diagnosis of 84 patients showed 40 solid masses,20 cystic masses,and 24 cystic solid masses.The accordance rates of solid mass,cystic mass,and cystic-solid mass diagnosed by transvaginal ultrasonography were 95.00%,100.00%,and 100.00%,which were higher than 70.00%,60.00%,and 83.33%of transabdominal ultrasonography,and the differences were all statistically significant(P<0.05).Conclusion Transvaginal ultrasonography can effectively improve the effectiveness of endometriosis examination and has important reference value,which can effectively improve the diagnostic coincidence rate,reduce the misdiagnosis rate,and is worthy of promotion and application in clinical practice.