经阴道三维超声在宫腔病变中的临床应用

Clinical application of transvaginal three-dimensional ultrasound in uterine cavity lesions

目的探讨经阴道三维超声(3D-TVS)在宫腔病变诊断中的临床应用价值。方法选取2022年1月至2023年12月宁夏医科大学总医院收治的154例宫腔病变患者作为研究对象。患者入院后常规进行3D-TVS检查,宫腔粘连者以宫腔镜检查为“金标准”,宫腔其他病变者以术后病理结果为“金标准”。以3D-TVS诊断结果与“金标准”进行比较,得出结论。结果154例宫腔病变患者,包含以下4种:子宫内膜息肉、宫腔粘连、子宫黏膜下肌瘤、子宫内膜癌,其所占例数及比例分别为70例(45.4%)、56例(36.4%)、18例(11.7%)、10例(6.5%)。3D-TVS诊断宫腔病变的总体诊断准确性为92.9%。3D-TVS在诊断下述病例中的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为:子宫内膜息肉(94.3%、94.0%、92.9%、95.2%、94.2%);宫腔粘连(92.9%、96.9%、94.5%、96.0%、95.5%);子宫黏膜下肌瘤(88.9%、98.5%、88.9%、98.5%、97.4%);子宫内膜癌(90%、99.3%、90%、99.3%、98.7%)。结论3D-TVS对诊断宫腔病变具有较高的诊断效能,且具有无创、安全、经济、可重复性强等优势,建议筛查宫腔病变时首选。

Objective To explore the clinical value of transvaginal three-dimensional ultrasound(3D-TVS)in the diagnosis of uterine cavity lesions.Methods A total of 154 uterine cavity lesions patients admitted to the General Hospital of Ningxia Medical University from January 2022 to December 2023 were selected as the study objects.After admission,the patient underwent routine 3D-TVS examination.Hysteroscopy was used as the"gold standard"for cases of intrauterine adhesions,and postoperative pathological results were used as the"gold standard"for cases of other intrauterine lesions.The diagnostic results of 3D-TVS with the"gold standard"were compared and conclusions were drawed.Results A total of 154 patients with uterine lesions,including the following four types:endometrial polyps,uterine adhesions,uterine submucous myoma,endometrial carcinoma,the number and proportion of cases were 70 cases(45.4%),56 cases(36.4%),18 cases(11.7%),10 cases(6.5%).The overall diagnostic accuracy of 3D-TVS in the diagnosis of uterine lesions was 92.9%.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 3D-TVS in the diagnosis of the following cases were as follows:endometrial polyps(94.3%,94.0%,92.9%,95.2%,94.2%);uterine adhesions(92.9%,96.9%,94.5%,96.0%,95.5%).Uterine submucous myoma(88.9%,98.5%,88.9%,98.5%,97.4%);endometrial carcinoma(90%,99.3%,90%,99.3%,98.7%).Conclusion 3D-TVS has high diagnostic efficacy in the diagnosis of uterine lesions,so it is suggested that the first choice is to screen uterine lesions.