彩色多普勒血流成像联合经阴道三维超声对宫腔粘连严重程度的评估

Evaluation of the severity of intrauterine adhesions using color Doppler flow imaging combined with transvaginal threedimensional ultrasound

目的探讨彩色多普勒血流成像(CDFI)联合经阴道三维超声(3D-TVS)对宫腔粘连严重程度的评估价值。方法选取接受宫腔镜治疗的190例宫颈粘连患者病历资料,依照宫腔镜所见及中国宫腔粘连诊断分级评分标准,将190例患者分为轻度组(n=24)、中度组(n=118)及重度组(n=48)。所有患者在宫腔镜治疗前均接受CDFI、3D-TVS检查,记录检查结果及检查参数,以宫腔镜检查结果为金标准,通过一致性分析CDFI联合3D-TVS对宫腔粘连严重程度的评估价值。结果3D-TVS、3D-TVS联合CDFI评估宫腔粘连结果与金标准结果的一致性分别为0.782、0.910,3D-TVS联合CDFI评估一致性最高。3D-TVS联合CDFI评估宫腔粘连严重程度准确度高于3D-TVS单独评估,差异有统计学意义(P<0.05)。三组宫腔容积(EV)、子宫内膜厚度(ED)、血管化指数(VI)、血管化血流指数(VFI)、血流指数(FI)、峰流速度(PSV)值比较,轻度组>中度组>重度组,差异有统计学意义(P<0.05)。三组血流阻力指数(RI)比较,轻度组<中度组<重度组,差异有统计学意义(P<0.05)。结论CDFI联合3D-TVS可提高宫腔粘连严重程度评估的一致性,具有较高的应用价值。

Objective To explore the value of color Doppler flow imaging(CDFI)combined with transvaginal threedimensional ultrasound(3D-TVS)in evaluating the severity of intrauterine adhesions.Methods Retrospective collection of medical records of 190 patients with cervical adhesions who received hysteroscopic treatment was conducted at the hospital from January 2022 to January 2024.According to the hysteroscopic findings and the Chinese grading system for the diagnosis of cervical adhesions,the 190 patients were divided into mild group(n=24),moderate group(n=118),and severe group(n=48).All patients underwent CDFI and 3D-TVS examinations before hysteroscopic treatment,and the examination results and parameters were recorded.The hysteroscopic examination results were used as the gold standard to explore the evaluation value of CDFI combined with 3D-TVS for the severity of uterine adhesions through consistency analysis.Results The consistency between 3DTVS and 3D-TVS combined with CDFI in evaluating intrauterine adhesions and the gold standard results was 0.782 and 0.910,respectively.The highest consistency was observed between 3D-TVS combined with CDFI in evaluating intrauterine adhesions.The accuracy of 3D-TVS combined with CDFI in evaluating the severity of intrauterine adhesions was higher than that of 3D-TVS alone,with statistical significant differences(P<0.05).The comparison of three groups of uterine cavity volume(EV),endometrial thickness(ED),vascularization index(VI),vascularization blood flow index(VFI),blood flow index(FI),and peak flow velocity(PSV)values showed that the mild group>moderate group>severe group,with statistical significant differences(P<0.05).The comparison of three groups of blood flow resistance index(RI)showed a statistically significant difference(P<0.05),with the mild group<moderate group<severe group.Conclusion The combination of CDFI and 3D-TVS can improve the consistency of assessing the severity of intrauterine adhesions and has high application value.