经阴道三维超声对宫腔粘连的定量诊断价值

Quantitative Evaluation of Intrauterine Adhesions by Transvaginal Three-dimensional Ultrasound

目的分析经阴道三维超声对宫腔粘连的定量诊断价值。方法纳入200例宫腔粘连疑似患者,2021年1月至2022年12月就诊,均经阴道二维超声和经阴道三维超声检查,以宫腔镜检查为金标准,对比两种方式在宫腔粘连中的诊断效能,对比两种方式对不同宫腔粘连程度的检出率和不同程度患者子宫定量参数的差异。结果经阴道三维超声诊断宫颈粘连的敏感性、特异性、准确性、阳性预测值、阴性预测值和对轻度宫腔粘连的检出率更高(P<0.05);经阴道三维超声对轻度宫腔粘连的检出率更高,组间对比有差异(P<0.05),而两种方式对中度、重度宫腔粘连检出率比较无差异(P>0.05)。两种诊断方式对不同类型患者的检出率对比有差异(P<0.05);阴性患者子宫内膜定量参数高于宫腔粘连患者(P<0.05);患者宫腔粘连程度越高,子宫内膜定量参数越低,不同程度患者两两对比有差异(P<0.05)。结论与经阴道二维超声比较,经阴道三维超声可准确诊断宫腔粘连,在粘连程度和疾病类型的诊断上更具优势;可通过测量血流参数的形式判定有无粘连,评估粘连程度。

Objective To analyze the quantitative diagnostic value of transvaginal three-dimensional ultrasound in intrauterine adhesions.Methods A total of 200 suspected patients with intrauterine adhesions were enrolled and treated from January 2021 to December 2022.All of them underwent transvaginal two-dimensional ultrasound and transvaginal three-dimensional ultrasound.Hysteroscopy was used as the gold standard to compare the diagnostic efficacy of the two methods in intrauterine adhesions.In addition,the detection rates of different degrees of uterine adhesions and uterine quantitative parameters of different degrees were compared between the two methods.Results The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and detection rate of mild intrauterine adhesions were higher in the diagnosis of cervical adhesions by transvaginal 3D ultrasound(P<0.05).Transvaginal three-dimensional ultrasound had a higher detection rate for mild intrauterine adhesions,with differences between groups(P<0.05),while there was no difference in the detection rate of moderate severe intrauterine adhesions between the two methods(P>0.05).The quantitative parameters of endometrial in negative patients were higher than those in patients with intrauterine adhesions(P<0.05).The higher the degree of intrauterine adhesions,the lower the quantitative parameters of endometrium,and there were differences in pairiness of patients with different degrees(P<0.05).Conclusion Transvaginal three-dimensional ultrasound can accurately diagnose intrauterine adhesions.Compared with transvaginal two-dimensional ultrasound,it has more advantages in the diagnosis of the degree of adhesions and disease types.The degree of adhesion can be evaluated by measuring blood flow parameters.