经阴道三维超声OmniView成像评价宫腔粘连程度的临床应用研究

Clinical application research of transvaginal three-dimensional ultrasound Omni View imaging to evaluate intrauterine adhesion and its degree

目的 分析经阴道三维超声自由解剖成像(Omni View成像)评价宫腔粘连程度的临床应用价值。方法 选择2020年6月至2022年3月义乌市中心医院75例疑似宫腔粘连接受宫腔镜诊治的患者作为研究对象,以宫腔镜检查结果作为金标准,通过一致性检验和受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析经阴道三维超声Omni View成像诊断宫腔粘连及其程度的应用价值。结果 65例患者经宫腔镜检查后确诊宫腔粘连,经阴道三维超声Omni View成像确诊61例患者为宫腔粘连,Omni View成像与宫腔镜诊断宫腔粘连的一致性检验Kappa=0.704,有较好的诊断一致性;Omni View成像诊断宫腔粘连的ROC曲线下面积(area under the curve,AUC)为0.912,诊断的敏感度、特异性和准确率分别为92.31%、90.00%和92.00%;以宫腔镜检查结果作为金标准,65例宫腔粘连患者中轻度36例、中度21例和重度8例;Omni View成像检出轻度34例、中度21例和重度10例,二者诊断宫腔粘连程度的一致性检验Kappa=0.869,有较好的诊断一致性;Omni View成像诊断轻度、中度和重度宫腔粘连的准确率分别为93.85%、93.85%和96.92%。结论 经阴道三维超声Omni View成像可有效用于宫腔粘连的诊断和宫腔粘连程度的分级,有较高的敏感度和特异性。

Objective To analyze the clinical value of transvaginal three-dimensional ultrasound free anatomy imaging(Omni View imaging) in evaluating intrauterine adhesions and its degree.Methods A total of 75 patients with suspected intrauterine adhesions admitted to Yiwu Central Hospital from June 2020 to March 2022 were selected as the research objects.The results of hysteroscopy were used as the gold standard.The consistency test and receiver operating characteristic curve(ROC curve) were used to analyze the application value of transvaginal three-dimensional ultrasound Omni View imaging in the diagnosis of intrauterine adhesions and their degree.Results 65 cases were diagnosed as intrauterine adhesions after hysteroscopy,and 61 cases were diagnosed as intrauterine by transvaginal three-dimensional ultrasound Omni View imaging.The consistency test Kappa value of transvaginal three-dimensional ultrasound Omni View imaging in the diagnosis of intrauterine adhesions and gold standard examination results was 0.704,which had good diagnostic consistency.The results of hysteroscopy were used as the gold standard.The area under the ROC curve of transvaginal three-dimensional ultrasound Omni View imaging in the diagnosis of intrauterine adhesions was 0.912,and the sensitivity,specificity and diagnostic accuracy were 92.31%,90.00% and 92.00%,respectively.Among the 65 patients with intrauterine adhesions,36 were mild,21 were moderate and 8 were severe.Omni View imaging of vaginal three-dimensional ultrasound detected 34 mild,21 moderate and 10 severe cases.The Kappa value of the consistency test between the diagnosis of intrauterine adhesions by transvaginal three-dimensional ultrasound Omni View imaging and the results of gold standard examination was 0.869,which had good diagnostic consistency.The accuracy of transvaginal three-dimensional ultrasound Omni View imaging in the diagnosis of mild,moderate and severe intrauterine adhesions was 93.85%,93.85% and 96.92%,respectively.Conclusion Transvaginal three-dimensional ultrasound Omni View imaging can be effectively applied to the diagnosis of intrauterine adhesions and the grading of intrauterine adhesions,with high sensitivity and specificity.