经阴道子宫三维成像技术与宫腔镜检查对人工流产后宫腔粘连诊断价值对比分析

Comparative analysis of the diagnostic value of transvaginal three-dimensional imaging technology and hysteroscopy in uterine adhesions after induced abortion

目的探究经阴道子宫三维成像技术与宫腔镜检查在人工流产后宫腔粘连诊断价值对比分析。方法选取我院2021年8月至2023年5月期间疑似有宫腔粘连的40例患者为此次研究的对象,并对其临床资料进行详细的分析,以宫腔镜检查以及病理检查为标准,对所有患者实施经阴道子宫三维成像技术与宫腔镜检查,判定经阴道子宫三维成像技术与宫腔镜检查的宫腔粘连的检出率、灵敏度以及特异度,并分析患者声像图资料与宫腔粘连程度的关系。结果经宫腔镜检查以及临床病理检查发现共有39例(97.5%)宫腔粘连患者,1例(2.5%)患者宫腔正常,其中轻度宫腔粘连有20例,中度宫腔粘连有15例,重度宫腔粘连有5例。经阴道子宫三维成像技术检查发现37例患者存在宫腔粘连,其检出率为92.5%(37/40),而宫腔镜检查出30例患者存在宫腔粘连,其检出率为75.0%(30/40),经阴道子宫三维成像技术检查宫腔粘连的检出率显著高于宫腔镜检查的检出率(χ^(2)=4.50,P<0.05);经阴道子宫三维成像技术检查宫腔粘连的灵敏度以及特异度(98.6%、97.7%),均高于宫腔镜检查的灵敏度和特异度(90.4%、91.2%)(P<0.05);经临床宫腔镜证实发现患者宫腔分离越明显,患者宫腔粘连程度越轻,而患者子宫内膜厚度越薄,患者的宫腔粘连程度越重。结论与宫腔镜检相比,经阴道子宫三维成像技术应用于宫腔粘连患者中具有较好的检出率、灵敏度以及特异度,能够有效提高临床上宫腔粘连的诊断,同时经过三维成像技术的声像图资料能够对不同程度的宫腔粘连患者进行诊断,帮助医生更好地诊断宫腔粘连程度。

Objective To explore the comparative analysis of the diagnostic value of transvaginal threedimensional imaging technology and hysteroscopy in uterine adhesions after induced abortion.Methods We selected 40 patients with suspected uterine adhesions from our hospital from August 2021 to May 2023 based on different examination methods as the subjects of this study.Then,we conducted a detailed analysis of the clinical data of 40 patients with suspected uterine adhesions,using hysteroscopy and pathological examination as the standards.Subsequently,we performed transvaginal three-dimensional imaging technology and hysteroscopy on all patients,Determine the detection rate,sensitivity,and specificity of uterine adhesions detected by transvaginal threedimensional imaging technology and hysteroscopy,and analyze the relationship between patient ultrasound data and the degree of uterine adhesions.Results Through hysteroscopy and clinical pathological examination,a total of 39(97.5%)patients with intrauterine adhesions were found,and 1(2.5%)patient had normal intrauterine adhesions,including 20 cases with mild intrauterine adhesions,15 cases with severe intrauterine adhesions,and 5 cases with severe intrauterine adhesions.Transvaginal three-dimensional imaging of the uterus revealed uterine adhesions in 37 patients,with a detection rate of 92.5%(37/40).Hysteroscopy revealed uterine adhesions in 30 patients,with a detection rate of 75.0%(30/40).The detection rate of uterine adhesions by transvaginal three-dimensional imaging of the uterus was significantly higher than that by hysteroscopy(χ^(2)=4.50,P<0.05).The sensitivity and specificity(98.6%,97.7%)of transvaginal three-dimensional imaging technology for detecting uterine adhesions were higher than those of hysteroscopy(90.4%,91.2%)(P<0.05),Clinical hysteroscopy has confirmed that the more obvious the separation of the patients′uterine cavity,the lighter the degree of adhesion in the patients′uterine cavity,and the thinner the thickness of the patient′s endometrium,the more severe the degree of adhesion in the patient′s uterine cavity.Conclusion Compared with hysteroscopy,the application of transvaginal three-dimensional imaging technology in patients with uterine adhesions has a better detection rate,face confidence,and specificity,which can effectively improve the diagnosis of uterine adhesions in clinical practice.At the same time,the ultrasound data obtained through three-dimensional imaging technology can diagnose patients with varying degrees of uterine adhesions,helping doctors better diagnose the degree of uterine adhesions.