阴道超声在子宫内膜病变诊断中的应用价值

Value of transvaginal ultrasonography in identification of endometrial lesions

目的探讨经阴道超声(TVUS)在诊断子宫内膜病变中的应用价值。方法选取162例中国人民解放军联勤保障部队第九八八医院2019年7月至2021年7月就诊的子宫内膜病变患者,所有患者入院时均行TVUS、经腹部超声(TAUS)检查,以病理检查结果为“金标准”,比较TVUS、TAUS检查对子宫内膜恶性病变诊断结果、诊断效能及对不同类型子宫内膜病变、不同分期子宫内膜癌的检出率。结果病理诊断结果显示,162例子宫内膜病变患者中,良性127例,恶性35例;经TVUS检查显示,良性130例,恶性32例;经TAUS检查显示,良性133例,恶性29例;与TAUS检查比较,TVUS检查诊断敏感度(95.7%)较高,漏诊率(14.3%)较低(P<0.05);与TAUS检查(85.7%)比较,TVUS检查对子宫内膜癌Ⅱ期、Ⅲ期、子宫内膜增生检出率更高(P<0.05)。结论TVUS可有效提高不同分期子宫内膜癌、不同类型子宫内膜病变诊断准确率,为临床早期定性诊断、制定治疗方案提供依据。

Objective To determine the value of transvaginal ultrasonography(TVUS)in identification of endometrial lesions.Methods A total of 162 patients with endometrial lesions who visited our hospital between July 2019 and July 2021 were included.On admission,all patients underwent TVUS and transabdominal ultrasonography(TAUS).With pathological findings as gold standard,TVUS and TAUS were compared on their diagnostic outcomes and efficacy for malignant endometrial lesions,the detection yields for different types of endometrial lesions and stages of endometrial cancer.Results Among the 162 patients with endometrial lesions,pathological identified benignity in 127 and malignancy in 35,TVUS identified benignity in 130 and malignancy in 32,TAUS identify benignity in 133 and malignancy in 29.Compared with TAUS(85.7%),TVUS showed higher diagnostic sensitivity(95.7%)and lower rate of missed diagnosis(14.3%)(P<0.05).Compared with TAUS,TVUS led to higher detection yield for stagesⅡ-Ⅲendometrial cancer,and endometrial hyperplasia(P<0.05).Conclusion TVUS can effectively improve the diagnostic accuracy of different stages of endometrial cancer and different types of endometrial lesions,and provides reliable reference for early qualitative diagnosis and treatment planning in clinical setting.