经阴道2D-TVS与腔内三维超声OmniView-VCI对周围型宫腔粘连的鉴别价值研究

Study on the Differential Value of Transvaginal 2D-TVS and Intracavitary Threedimensional Ultrasound OmniView-VCI in Peripheral Intrauterine Adhesions

目的探究经阴道二维超声(transvaginal 2-dimensional ultrasound,2D-TVS)与腔内三维超声自由解剖切面(OmniView)联合容积对比成像(volume contrast imaging,VCI)对周围型宫腔粘连(intrauterine adhesion,IUA)的鉴别价值。方法选取2022年3月—2023年3月东莞市中西医结合医院收治的77例疑似IUA女性患者,以临床综合诊断为金标准,对患者行2D-TVS、腔内三维超声OmniView-VCI检查及宫腔镜(hysteroscope,HS)检查,将2D-TVS与OmniView-VCI检查和HS检查比较,分析二者对周围型IUA的鉴别价值。结果HS检查发现周围型IUA占90.91%(70/77),无粘连占9.09%(7/77);经2D-TVS检查诊断周围型IUA51例,非粘连26例;经OmniView-VCI检查诊断周围型IUA61例,非粘连16例;2D-TVS、OmniView-VCI诊断周围型IUA的特异度、阳性预测值、阴性预测值比较,差异无统计学意义(P>0.05),但OmniView-VCI诊断周围型IUA的敏感度85.71%、准确率85.71%显著高于2D-TVS,差异有统计学意义(χ^(2)=6.701、8.944,P<0.05)。结论2D-TVS与腔内三维超声OmniView-VCI均能鉴别周围型IUA,且OmniView-VCI对周围型IUA诊断价值更高。

Objective To explore the value of transvaginal 2-dimensional ultrasound(2D-TVS)and intravenously 3-dimensional ultrasound free anatomical section(OmniView)combined with volumetric contrast imaging(VCI)in differentiating intrauterine adhesions(IUA).Methods A total of 77 female patients with suspected IUA admitted to Dongguan Hospital of Integrated Chinese and Western Medicine from March 2022 to March 2023 were selected.With comprehensive clinical diagnosis as the gold standard,2D-TVS,OmniView-VCI and hysteroscopy(HS)were performed on the patients.2D-TVS was compared with OmniView-VCI and HS examination to analyze the value of them in the identification of peripheral IUA.Results HS examination showed that peripheral IUA accounted for 90.91%(70/77)and no adhesion accounted for 9.09%(7/77).After 2d-TVS examination in the diagnosis of peripheral IUA51 example,the adhesion of 26 cases;The OmniView-check out the diagnosis of peripheral IUA61 example,VCI not adhesion 16 cases;there were no significant differences in specificity,positive predictive value and negative predictive value between 2D-TVS and OmniView-VCI in the diagnosis of peripheral IUA(P>0.05),but the sensitivity and accuracy of OmniView-VCI in the diagnosis of peripheral IUA were 85.71%and 85.71%,respectively,which were significantly higher than those of 2D-TVS,the differences were statistically significant(χ^(2)=6.701,8.944,P<0.05).Conclusion Both 2D-TVS and intracavitary three-dimensional ultrasound OmniView-VCI can identify peripheral IUA,and OmniView-VCI has a higher diagnostic value for peripheral IUA.