3D-TVS及自由解剖成像技术诊断黏膜下子宫肌瘤分型的临床研究

Clinical Study of 3D-TVS and Free Anatomic Imaging Technique in the Diagnosis of Submucosal Uterine Fibroids

目的 研究经阴道三维超声(3D-TVS)及自由解剖成像技术(Omniview)在黏膜下子宫肌瘤(UF)分型诊断中的临床价值。方法 选择92例疑为黏膜下UF患者,均进行2D-TVS、3D-TVS+Omniview检查。以最终病理结果作为金标准,计算2D-TVS及3D-TVS+Omniview诊断黏膜下UF结果与病理结果的一致性,以及2D-TVS及3D-TVS+Omniview诊断黏膜下UF分型的敏感度。结果 92例疑为黏膜下UF患者经病理结果证实黏膜下UF患者78例;2D-TVS诊断黏膜下UF结果与病理诊断结果一致性较为理想(Kappa=0.567,P=0.000);3D-TVS+Omniview诊断黏膜下UF结果与病理诊断结果一致性极好(Kappa=0.774,P=0.000)。3D-TVS+Omniview诊断Ⅱ型黏膜下UF敏感度(88.89%)高于2D-TVS(59.26%),差异有统计学意义(P<0.05);3D-TVS+Omniview与2D-TVS诊断0型、Ⅰ型黏膜下UF敏感度比较,差异无统计学意义(P>0.05)。结论 3D-TVS及Omniview诊断黏膜下UF与病理诊断结果的一致性极好,且在黏膜下UF分型诊断中敏感度高,临床可采用3D-TVS及Omniview对黏膜下UF进行诊断及分型,为患者术前评估及手术方案的制定提供参考。

Objective To investigate the clinical value of three-dimensional transvaginal ultrasound(3D-TVS) and free anatomic imaging(Omniview) in the diagnosis of submucosal uterine fibroids(UF).Methods 92 patients with suspected submucosal UF were selected.All 92 suspected submucosal UF patients were examined by 2D-TVS and 3D-TVS+Omniview.Final pathological results were used as the gold standard to calculate the consistency between the results of 2D-TVS and 3D-TVS+Omniview in the diagnosis of submucosal UF and pathological results,and the sensitivity of 2D-TVS and 3D-TVS+Omniview in the diagnosis of submucosal UF.Results Submucosal UF was confirmed by pathological results in 78 of 92 patients.The results of aubmucosal UF in 2D-TVS diagnosis were in good agreement with pathological diagnosis(Kappa=0.567,P=0.000).The UF result of 3D-TVS+Omniview diagnosis was in excellent agreement with pathological diagnosis(Kappa=0.774,P=0.000).The UF sensitivity of 3D-TVS+Omniview in the diagnosis of type Ⅱ submucosa(88.89%) was higher than that of 2D-TVS(59.26%),and the difference was statistically significant(P<0.05).There was no significant difference between 3D-TVS+Omniview and 2D-TVS in the diagnosis of submucosal UF sensitivity of type 0 and type Ⅰ(P>0.05).Conclusion 3D-TVS and Omniview have excellent consistency with pathological diagnosis of SUBmucosal UF,and have high sensitivity in submucosal UF typing.3D-TVS and Omniview can be used in clinical diagnosis and typing of submucosal UF,to provide reference for preoperative evaluation of patients and the formulation of surgical plan.