三维超声自由解剖成像联合断层超声成像对宫腔粘连的诊断价值

Diagnostic value of three-dimensional ultrasound freehand anatomical imaging combined with tomographic ultrasound imaging for intrauterine adhesions

目的探讨三维超声自由解剖成像(OmniView)联合断层超声成像(TUI)对宫腔粘连(IUA)的诊断价值。方法选取我院收治的112例疑似IUA患者,均行OmniView和TUI检查,比较OmniView、TUI单独及联合应用诊断IUA情况,并与宫腔镜检查结果进行一致性分析;绘制受试者工作特征(ROC)曲线分析OmniView、TUI单独及联合应用对IUA的诊断效能。结果112例患者中,宫腔镜检出IUA 98例,其中中央型62例,周围型11例,混合型25例;非IUA 14例。OmniView检出IUA 93例,其中中央型59例,周围型10例,混合型24例;非IUA患者19例。TUI检出IUA 88例,其中中央型58例,周围型7例,混合型23例;非IUA患者24例。OmniView及TUI检出IUA与宫腔镜检查结果的一致性均一般(Kappa=0.681、0.625,均P<0.001),联合应用与宫腔镜检查结果的一致性较好(Kappa=0.813,P<0.001)。ROC曲线分析显示,OmniView联合TUI诊断IUA的曲线下面积、灵敏度、特异度和准确率分别为0.939、95.92%、92.86%、95.54%,AUC高于各方法单独应用(均P<0.05)。结论OmniView联合TUI对IUA具有较好的诊断价值,可用于临床筛查。

Objective To explore the value of three-dimensional ultrasound freehand anatomical imaging(OmniView)combined with tomographic ultrasound imaging(TUI)in the diagnosis of intrauterine adhesions(IUA).Methods A total of 112 patients with suspected IUA admitted to our hospital were selected,and all patients underwent OmniView and TUI examination.The results of hysteroscopy were used as the gold standard to analyze the consistency of IUA examined by OmniView,TUI alone and in combination.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of OmniView,TUI alone and in combination for IUA.Results Among 112 patients,98 cases of IUA were detected by hysteroscopy,including 62 cases of central type,11 cases of peripheral type and 25 cases of mixed type,and 14 cases of non-IUA.93 cases of IUA were detected by OmniView,including 59 cases of central type,10 cases of peripheral type,and 24 cases of mixed type,and 19 cases of non-IUA.88 cases of IUA were detected by TUI,including 58 cases of central type,7 cases of peripheral type,and 23 cases of mixed type,and 24 cases of non-IUA.The consistency of OmniView and TUI in detecting IUA was general(Kappa=0.681,0.625,both P<0.001),and the consistency of combined detection was better(Kappa=0.813,P<0.001).ROC curve analysis showed that the area under the curve,sensitivity,specificity and accuracy of OmniView combined with TUI in the diagnosis of IUA were 0.939,95.92%,92.86%and 95.54%,respectively.AUC of combined detection was higher than that of each alone(both P<0.05).Conclusion OmniView combined with TUI have good value in the diagnosis of IUA,which can be used for clinical screening.