经阴道彩色多普勒超声联合宫腔镜检查诊断宫腔内占位性病变的价值

Clinical value of transvaginal color Doppler ultrasonography combined with hysteroscopy in diagnosis of intrauterine space-occupying lesions

目的探讨经阴道彩色多普勒超声(TVCDU)联合宫腔镜检查诊断宫腔内占位性病变的价值。方法抽取2020年1月至2022年12月联勤保障部队第九八九医院收治的宫腔内占位性病变患者78例,均实施TVCDU和宫腔镜检查,以病理检查结果为"金标准",统计TVCDU、宫腔镜单独和联合检查的诊断结果和诊断效能,分析预测值。结果78例宫腔内占位性病变患者中,经病理检查确诊为恶性33例,良性45例;TVCDU诊断出真恶性22例,真良性37例;宫腔镜诊断出真恶性24例,真良性38例;TVCDU联合宫腔镜诊断出真恶性32例,真良性42例;TVCDU联合宫腔镜灵敏度(96.97%,32/33)、准确度(94.87%,74/78)高于TVCDU诊断(66.67%,22/33;75.64%,59/78)和宫腔镜诊断(72.73%,24/33;79.49%,62/78),漏诊率(3.03%,1/33)低于TVCDU诊断(33.33%,11/33)和宫腔镜诊断(27.27%,9/33),P<0.05;TVCDU联合宫腔镜诊断的良性预测值(97.67%,42/43)高于TVCDU诊断(77.08%,37/48)和宫腔镜诊断(80.85%,38/47),P<0.05。结论TVCDU联合宫腔镜检查用于诊断宫腔内占位性病变,能明显提升恶性病变诊断的灵敏度和准确度,减少漏诊情况的发生,且预测值良好。

Objective To investigate the clinical value of transvaginal color Doppler ultrasound(TVCDU)combined with hysteroscopy in the diagnosis of intrauterine space-occupying lesions.Methods A total of 78 patients with intrauterine space-occupying lesions treated in NO.989 Hospital of Joint Support Force from January 2020 to December 2022 were selected.They all underwent TVCDU and hysteroscopy.Pathological examination results were taken as the gold standard to analyze the diagnostic results and diagnostic efficacy of TVCDU,hysteroscopy and combination of them.And the predictive value was analyzed.Results Among the 78 patients with intrauterine space-occupying lesions,33 cases were malignant,and 45 cases were benign.TVCDU identified 22 cases of true malignancy and 37 cases of true benign.Hysteroscopy identified 24 cases of true malignancy and 38 cases of true benign;TVCDU combined with hysteroscopy identified 32 cases of true malignancy and 42 cases of true benign.The sensitivity and accuracy of TVCDU combined with hysteroscopy were 96.97%(32/33)and 94.87%(74/78),higher than those of TVCDU(66.67%,22/33;75.64%,59/78)and hysteroscopy identified(72.73%,24/33;79.49%,62/78).The missed diagnosis rate of TVCDU combined with hysteroscopy was 3.03%(1/33),lower than that the 33.33%(11/33)of TVCDU and 27.27%(9/33)of hysteroscopy(P<0.05).The benign predictive value of TVCDU combined with hysteroscopy was 97.67%(42/43),higher than that of TVCDU(77.08%,37/48)and hysteroscopy(80.85%,38/47),P<0.05.Conclusions TVCDU combined with hysteroscopy in the diagnosis of intrauterine space-occupying lesions can significantly improve the sensitivity and accuracy of malignant lesions,and reduce the occurrence of missed diagnosis,which has good predictive value.