经阴道超声与经腹部超声诊断子宫内膜病变的临床价值

Clinical value of transvaginal ultrasound versus transabdominal ultrasound in the diagnosis of endometrial lesions

目的探究经阴道超声与经腹部超声诊断子宫内膜病变的临床价值。方法选取2020年5月至2021年3月本院收治的100例疑似子宫内膜病变患者作为研究对象,均进行经阴道超声、经腹部超声检查。以病理活检、宫腔镜等综合检查为金标准,比较经阴道超声与经腹部超声检查的疾病总检出率、诊断效能,比较经阴道超声检查良恶性病变患者动脉阻力指数、血流动力指数。结果经宫腔镜和病理活检显示,100例患者中,确诊宫内膜病变85例,其中良性61例,恶性24例。经阴道超声检查疾病总检出率为96.47%,明显高于经腹部超声检查的84.71%,差异有统计学意义(P<0.05)。经阴道超声检查的诊断符合率、灵敏度、阴性预测值均高于经腹部超声检查,漏诊率低于经腹部超声检查,差异有统计学意义(P<0.05),两种检查方法的特异度、阳性预测值、误诊率比较差异无统计学意义。恶性病变患者动脉阻力指数高于良性病变患者,血流动力指数低于良性病变患者,差异有统计学意义(P<0.05)。结论经阴道超声检查诊断子宫内膜病变效能较高,能准确显示病灶的血流信号,鉴别和诊断疾病类型。

Objective To investigate the clinical value of transvaginal ultrasound versus transabdominal ultrasound in the diagnosis of endometrial lesions.Methods 100 patients with suspected endometrial lesions admitted to our hospital from May 2020 to March 2021 were selected as the study subjects,all of whom underwent transvaginal ultrasound and transabdominal ultrasound examination.With pathological biopsy,hysteroscopy and other comprehensive examination as the gold standard,the total disease detection rate and diagnostic efficacy of transvaginal ultrasound and transabdominal ultrasound were compared,and the arterial resistance index and hemodynamic index in patients with benign and malignant lesions were compared by transvaginal ultrasound.Results Hysteroscopy and pathological biopsy showed that among the 100 patients,85 cases of endometrial lesions were confirmed,of which 61 cases were benign and 24 cases were malignant.The total detection rate of transvaginal ultrasound was 96.47%,which was significantly higher than 84.71%of transabdominal ultrasound,and the difference was statistically significant(P<0.05).The diagnostic coincidence rate,sensitivity,negative predictive value of transvaginal ultrasound were higher than those of transabdominal ultrasound,and the missed diagnosis rate was lower than that of transabdominal ultrasound,and the differences were statistically significant(P<0.05),there were no significant difference in the specificity,positive predictive value and misdiagnosis rate between the two methods.The arterial resistance index of patients with malignant lesions was higher than that of patients with benign lesions,and the hemodynamic index was lower than that of patients with benign lesions,the differences were statistically significant(P<0.05).Conclusion Transvaginal ultrasound is highly effective in diagnosing endometrial lesions,accurately showing the blood flow signal of the lesion and identifying and diagnosing the type of disease.