Comparison of the application value of transvaginal ultrasound and transabdominal ultrasound in the diagnosis of ectopic pregnancy

BACKGROUND Ectopic pregnancy(EP) is one of the most common acute abdominal diseases in gynecology. Once the condition of EP is delayed, it may lead to massive hemorrhage, shock, and even death in a short time, seriously threatening the patient’s life. Early diagnosis is the key to preventing and improving the prognosis of EP.Transabdominal ultrasound(TAS) and transvaginal ultrasound(TVS) are the main diagnostic methods for abdominal diseases. The purpose of this study is to explore the application value and effect of TAS and TVS in the diagnosis of EP,hoping to provide more valuable references for the diagnosis of EP.AIM To explore the application value of TAS and TVS in the diagnosis of EP and to improve the level of clinical diagnosis.METHODS A total of 140 patients with EP admitted to our hospital from July 2018 to July 2020 were selected for this study. All patients were divided into two groups according to the examination methods. 63 patients who underwent abdominal ultrasound examination were set as the TAS group, while 77 patients who underwent TVS examination were set as the TVS group. We compared the diagnostic accuracy and misdiagnosis rates between the two types of ultrasound examinations, as well as the postoperative pathological results of the two diagnostic methods for different types of ectopic pregnancies. We also analyzed the sonograms for the presence of mixed ectopic masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the ectopic sac shadow, and the detection of fluid in the rectal fossa of the uterus, such as the adnexal area, yolk sac, and embryo, etc. In addition, the diagnosis time, days of gestational sac appearance, operation time, endometrial thickness, and blood flow resistance index were compared as well.RESULTS After performing both types of ultrasound examinations in 140 patients with EP, we found that the diagnostic accuracy of TVS was significantly higher than that of TAS, and the misdiagnosis rate was significantly lower than that of TAS. The differences were statistically significant(P < 0.05). In addition, the detection rate of TVS was better than that of TAS for the presence of mixed masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the shadow of the ectopic sac, and sonograms such as the adnexal area, yolk sac, and embryo,etc. The coincidence rate of its postoperative pathological examination results was significantly higher than those of TAS. The diagnosis time and the days of gestational sac appearance by TVS were significantly shorter than that by TAS, and the operation time was earlier than that by TAS.What’s more, the detection rates of the endometrial thickness ￡ 1.5 mm and blood flow resistance ￡0.5 were significantly higher in TVS diagnosis of EP than in TAS. All differences were statistically significant(P < 0.05).CONCLUSION Compared with TAS, TVS has the advantages of high detection accuracy and good sonogram performance.

3D-TAS联合3D-TVS检查在剖宫产术后瘢痕妊娠早期诊断及分型中的应用价值

目的评估经腹部三维超声(3D-TAS)联合经阴道三维超声(3D-TVS)检查在剖宫产术后瘢痕妊娠(CSP)患者早期诊断和分型中的应用价值。方法选取2020年3月至2023年3月洛阳市第一人民医院收治的疑似CSP者135例,均接受3D-TAS、3D-TVS检查,以术后病理作为“金标准”,分析3D-TAS、3D-TVS单独及联合检查在CSP者早期诊断和分型中的价值。结果135例疑似CSP患者中,术后病理证实CSP 100例(74.07%),非CSP 35例(25.93%)。且3D-TAS与3D-TVS联合检查诊断早期CSP的敏感度、准确率均明显高于3D-TAS、3D-TVS单独检查,而漏诊率、阴性预测值均明显低于3D-TAS、3D-TVS单独检查,差异均有统计学意义(P<0.05)。术后病理证实,100例CSP患者中Ⅰ型25例、Ⅱ型57例、Ⅲ型18例;3D-TAS、3D-TVS联合检查分型结果:Ⅰ型18例、Ⅱ型45例、Ⅲ型17例,分型检出率为80.00%(80/100),与病理结果CSP分型一致性检验较好(Kappa值为0.769,95%可信区间0.598~0.881,P<0.001)。结论3D-TAS、3D-TVS联合检查对CSP患者具有较高的早期诊断价值,并能为CSP分型诊断提供可靠依据,故可作为剖宫产术后再次妊娠患者筛查CSP的首选方式。

Twin fetuses associated with double amniotic sacs diagnosed using transvaginal ultrasonography:A case report

BACKGROUND Conjoined twins are a rare twin malformation commonly presenting as single amniotic sac twinning,with double amniotic sac twinning being extremely rare and poorly reported.Most conjoined twins are females.CASE SUMMARY A woman of childbearing age conceived naturally,and at 8 wk of gestation,transvaginal ultrasonography showed an embryo and cardiac tube pulsation in both amniotic sacs.On dynamic observation,the two embryos were connected in the lower abdomen,with restricted movement.A repeat transvaginal ultrasound at 11 wk showed that the intestinal tubes of both fetuses were connected in the lower abdomen.The pregnancy was terminated and labor was induced.CONCLUSION Transvaginal ultrasound may detect conjoined twin malformations in an early stage.Our case provides diagnostic insights for ultrasonographers and can help develop early therapeutic interventions.

3D-TVS及自由解剖成像技术诊断黏膜下子宫肌瘤分型的临床研究

目的 研究经阴道三维超声(3D-TVS)及自由解剖成像技术(Omniview)在黏膜下子宫肌瘤(UF)分型诊断中的临床价值。方法 选择92例疑为黏膜下UF患者,均进行2D-TVS、3D-TVS+Omniview检查。以最终病理结果作为金标准,计算2D-TVS及3D-TVS+Omniview诊断黏膜下UF结果与病理结果的一致性,以及2D-TVS及3D-TVS+Omniview诊断黏膜下UF分型的敏感度。结果 92例疑为黏膜下UF患者经病理结果证实黏膜下UF患者78例;2D-TVS诊断黏膜下UF结果与病理诊断结果一致性较为理想(Kappa=0.567,P=0.000);3D-TVS+Omniview诊断黏膜下UF结果与病理诊断结果一致性极好(Kappa=0.774,P=0.000)。3D-TVS+Omniview诊断Ⅱ型黏膜下UF敏感度(88.89%)高于2D-TVS(59.26%),差异有统计学意义(P<0.05);3D-TVS+Omniview与2D-TVS诊断0型、Ⅰ型黏膜下UF敏感度比较,差异无统计学意义(P>0.05)。结论 3D-TVS及Omniview诊断黏膜下UF与病理诊断结果的一致性极好,且在黏膜下UF分型诊断中敏感度高,临床可采用3D-TVS及Omniview对黏膜下UF进行诊断及分型,为患者术前评估及手术方案的制定提供参考。

TVS、TAS与β-HCG、孕酮、E_(2)在早期输卵管妊娠中的联合诊断价值

目的 探究经阴道超声(TVS)、经腹部超声(TAS)与β-人绒毛膜促性腺激素(β-HCG)、孕酮、雌二醇(E_(2))在早期输卵管妊娠中的联合诊断价值。方法 选取北京市通州区妇幼保健院2020年1月—2021年1月疑似输卵管妊娠患者117例作为研究对象,均行TVS、TAS检查及血清β-HCG、孕酮、E_(2)水平检测。结果 117例疑似输卵管妊娠患者经临床确诊90例为输卵管妊娠,27例为正常妊娠。受试者工作特征(ROC)曲线分析显示,TVS、TAS检查及两者联合检查诊断输卵管妊娠的ROC曲线下面积(AUC)分别为0.715、0.661、0.728。输卵管妊娠组血清β-HCG、孕酮、E_(2)水平低于正常妊娠组(P<0.05);血清β-HCG、孕酮、E_(2)及三者联合诊断输卵管妊娠的AUC分别为0.908、0.922、0.701、0.944。TVS、TAS阳性检出率与血清β-HCG、孕酮、E_(2)水平呈负相关(P<0.05)。TVS、TAS检查联合血清β-HCG、孕酮、E_(2)诊断输卵管妊娠的AUC为0.967,95%CI为0.940~0.994,敏感度为87.78%,特异度为96.30%,高于各项检查单一诊断价值、TAS联合TVS诊断价值及血清β-HCG、孕酮、E_(2)联合诊断价值。结论 早期输卵管妊娠TVS、TAS阳性检出率与血清β-HCG、孕酮、E_(2)水平呈负相关,联合诊断价值较高,能为临床诊断早期输卵管妊娠提供较为全面、可靠的参考依据。

Detection of Congenital Uterine Malformation by Using Transvaginal Three-dimensional Ultrasound

This study assessed the clinical application of transvaginal three-dimensional ultrasound （3D TVUS） in the diagnosis of congenital uterine malformation. A retrospective study was performed on 62 patients with congenital uterine malformation confirmed hysteroscopically and/or laparoscopically. The patients were subjected to transvaginal two-dimensional ultrasound （2D TVUS） and 3D TVUS. The accuracy rate was compared between the two methods. The accuracy rate of 3D TVUS was （98.38%, 61/62）, higher than that of 2D TVUS （80.65%, 50/62）. 3D TVUS coronal plane imaging could demon- strate the internal shape of the endometrial cavity and the external contour of the uterine fundus. It al- lowed accurate measurement on the coronary plane, and could three-dimensionally show the image of cervical tube, thereby providing information for the diagnosis of some complex uterine malformation. 3D TVUS imaging can obtain comprehensive information of the uterus malformation, and it is superior to 2D TVUS for the diagnosis of congenital uterine malformations, especially complex uterine anomaly.

MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report

Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding.In our current case,a 76-year-old woman presented with irregular vaginal bleeding.The final pathological diagnosis of the mass was APA.APA is not easy to diagnose before surgery.On the one hand,there was no obvious particularity in imaging features and clinical features,especially for uncomfortably identifying endometrial cancer.On the other hand,APA has a pedicle,attaching to any part of the uterine cavity,which can cause pseudocoel between the mass with the uterine cavity wall.So,when it comes to getting the pathological tissue in the absence of hysteroscopy,it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass.Therefore,preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA.In the meantime,pathological tissue of APA can be obtained by hysteroscopy in visual conditions.

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

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。

Transvaginal 3D Ultrasound Evaluation of Post-Cesarean Section Uterine Diverticulum

Objectives: This study focused on evaluating the value of transvaginal 3D ultrasound for the diagnosis and prognostic assessment of post-cesarean section uterine diverticulum. Materials and Methods: We retrospectively analyzed the data from 32 patients with post-cesarean section uterine diverticulum over three recent years. In all patients, transvaginal 3D ultrasound was used to measure the size of the uterine diverticulum and the thickness of the lower uterine segment (LUS) and myometrium. Patients with a LUS with a myometrial thickness under 4 mm underwent resection and repair surgery;those with a LUS with a myometrial thickness over 4 mm underwent hysteroscopic resection. The postoperative sonograms were compared with preoperative images to evaluate the efficacy of various treatments. Results: The mean length, width and depth of the uterine diverticula were 18.30 ± 2.80 mm, 9.14 ± 3.20 mm and 11.49 ± 2.71 mm, respectively. The average LUS myometrial thickness was 3.40 ± 0.80 mm (with a range of 1.6 mm - 6.3 mm). After surgery, two patients’ sonograms still showed diverticula at the post-cesarean section scar, measuring 6 mm × 7 mm × 6 mm and 6 mm × 8 mm × 4 mm. There were significant differences in the size of uterine diverticula between preoperative and postoperative sonograms (P < 0.05) and the effective rate of surgery was 93.75% (30/32). Conclusions: Transvaginal 3D ultrasound is an accurate method for detecting post-cesarean section uterine diverticulum and is helpful for assessing surgical options and prognosis. The LUS myometrial thickness, which is considered as an optional index of post-cesarean section uterine diverticulum, should be measured routinely.

The Value of Transvaginal Ultrasound in Clinical Surgical Treatment of Cesarean Scar Pregnancy

The clinical value of transvaginal ultrasound in clinical surgical treatment of cesarean scar pregnancy（CSP） was evaluated. The clinical data of 104 patients with CSP admitted at Tongji Hospital from 2013 to 2016 were collected and analyzed retrospectively, including the patients＇ age, gestational age, the size of gestational sac or uneven mass, the uterine scar thickness, β human chorionic gonadotropin（h CG） levels and so on. Of these 104 cases, 30 cases were subjected to laparotomy, 29 cases to laparoscopy, 27 cases to hysteroscopy, 16 cases to ultrasound-guided uterine curettage, and 2 cases to conservative treatment. The transvaginal ultrasound showed that uterine scar thickness and gestational sac or uneven mass size had significant difference（P〈0.05） among different surgical methods by comparatively analyzing the patients＇ data. It was suggested that transvaginal ultrasound may provide the valuable reference for choosing clinical surgical procedures for CSP.

A Comparative Observational Study of the Use Transvaginal Ultrasound and Hysteroscopy for the Detection of Uterine Cavity Pathologies in Women with Abnormal Uterine Bleeding

Background: 70% of all gynecological consultations are for abnormal uterine bleeding. Any approach to optimal management begins with an appropriate diagnosis. 40% of premenopausal women with abnormal uterine bleeding were found to have some intrauterine pathology. This study aims to compare the diagnostic value of transvaginal ultrasonography in comparison to hysteroscopy in detecting uterine abnormalities in patients with abnormal uterine bleeding. Methods: Retrospective observational cross sectional study of 250 women presented with abnormal uterine bleeding. The patients who fulfilled the selection criteria and have been sequentially investigated by transvaginal ultrasound (TVS) and hysteroscopy were included. Results: 90% of patients were from 35 - 49 yrs. 81.2% of patients have body mass index above 25 kg/m2. Transvaginal ultrasound (TVS) compared well with high sensitivity as regards normal endometrium. (TVS) missed 4 patients of endometrial polyps and one patient of sub mucous fibroid. Three patients of adenomyosis were only diagnosed by (TVS);they were reported as being normal by hysteroscopy. Conclusion: (TVS) is considered as an excellent approach to the initial evaluation of uterine pathologies in patients with abnormal uterine bleeding.

Vaginal Touch versus Transvaginal Ultrasound in the Management of Threatened Preterm Labour at the University Hospital Center of Porto-Novo (Benin)

Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 - 3.20)] and ultrasound examination of cervical length - 4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.

The Clinical Value of Ultrasound Image Texture Analysis in the Diagnosis of Uterine Adhesions

Purpose: This review examines the diagnostic value of transvaginal 3D ultrasound image texture analysis for the diagnosis of uterine adhesions. Materials and Methods: The total clinical data of 53 patients with uterine adhesions diagnosed by hysteroscopy and the imaging data of transvaginal three-dimensional ultrasound from the Second Affiliated Hospital of Chongqing Medical University from June 2022 to August 2023 were retrospectively analysed. Based on hysteroscopic surgical records, patients were divided into two independent groups: normal endometrium and uterine adhesion sites. The samples were divided into a training set and a test set, and the transvaginal 3D ultrasound was used to outline the region of interest (ROI) and extract texture features for normal endometrium and uterine adhesions based on hysteroscopic surgical recordings, the training set data were feature screened and modelled using lasso regression and cross-validation, and the diagnostic efficacy of the model was assessed by applying the subjects’ operating characteristic (ROC) curves. Results: For each group, 290 texture feature parameters were extracted and three higher values were screened out, and the area under the curve of the constructed ultrasonographic scoring model was 0.658 and 0.720 in the training and test sets, respectively. Conclusion Relative clinical value of transvaginal three-dimensional ultrasound image texture analysis for the diagnosis of uterine adhesions.

Comparison of Bishop score and cervical length measurement through transvaginal ultrasound as prediction against labor induction

Objective:To compare the Bishop score and cervical length measured by transvaginal ultrasound concerned with prediction over the success of labor induction.Methods:This cross-sectional observational analytical study was conducted from May 2017 to October 2017 at several teaching hospitals of Obstetrics and Gynecology Department, Faculty of Medicine Hasanuddin University of Makassar, India. There were 110 samples of pregnant women undergoing labor induction process including 79 samples of successful induction and 31 samples of induction failure. The data analysis used Pearson Chi-square test and multivariate logistic regression to see the effect of Bishop score and measurement of cervical length with successful induction of labor.Results: Number of samples with successful labor induction with Bishop score <3 was 25 (31.6%) and Bishop score≥3 was 54 (68.4%), with rate ratio=3.714 andP=0.000. With measurement of cervical length (cut-off point 2.98 cm), number of samples with successful labor induction with cervical length≤2.98 cm was 12 (15.2%) and cervical length >2.98 cm was 67 (84.8%), with rate ratio=3.124 andP=0.000. Multivahate analysis of logistic regression was found to be more influential in the predicted success of labor induction (P=0.014 with Bishop score <3, odds ratio=1.000 and Bishop score≥3, odds ratio=3.779. Conclusions: Bishop score is better in predicting the success of labor induction compared to the measurement of cervical length through transvaginal ultrasound.

Accuracy of Transvaginal Ultrasound in Prediction of Latency Period in Women with Preterm Premature Rupture of Membranes

Background: Preterm prelabor rupture of membranes (PPROM) is a major cause of Pretem Birth (PTB), Pretem Birth (PTB) is the most significant cause of perinatal morbidity and mortality worldwide. Cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) have been postulated in several studies to have an important role in prediction of PTB. Up to our knowledge, this is the first study that combines the three cervical parameters in prediction of latency period in women with PPROM. Aim of the Work: To assess the accuracy of cervical length, posterior uterocervical angle and anterior uterocervical angle in prediction of latency period in women with Preterm prelabor rupture of membranes. Subjects and Methods: A Prospective cohort study on 205 women with PPROM was held at Ain Shams University Maternity Hospital, a transvaginal ultrasound was performed to measure cervical length, posterior uterocervical angle, anterior uterocervical angle. Results: A total of 205 pregnant women with PPROM were included in this study, the latency grade was within 2 days in 57 (27.8%) of cases while was after 2 days in 148 (72.2%) of cases. As regards cervical length cut-off value 25.0 mm, sensitivity was 78.9%, specificity was 65.5%, posterior uterocervical angle cut-off value 108.0°, sensitivity was 93.0%, specificity was 60.1%, and anterior uterocervical angle cut-off value 106.0°, sensitivity was 93.0%, specificity was 71.6%. Conclusion: The combination of cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) measurements greatly predicts the latency period in women with PPROM, and Anterior uterocervical angle (AUCA) ≥ 106.0° had the highest diagnostic value in predicting latency period within two days.

TVUS联合MRI对早期宫颈癌术前分期的诊断价值研究

目的研究经阴道超声(TVUS)联合磁共振成像(MRI)对早期宫颈癌术前分期的诊断价值。方法收集86例经手术病理证实的宫颈癌(ⅠB、ⅡA、ⅡB期)患者,术前均行TVUS和MRI检查。与手术病理结果相对照,比较TVUS、MRI及TVUS+MRI对宫颈癌分期的诊断结果;比较TVUS、MRI及TVUS+MRI对病变的检出情况;分析TVUS+MRI与手术病理分期的一致性。结果86例宫颈癌的手术病理结果包括ⅠB期22例(ⅠB1期6例、ⅠB2期9例、ⅠB3期7例),ⅡA期32例(ⅡA1期12例、ⅡA2期20例),ⅡB期32例。TVUS、MRI对宫颈癌分期的诊断准确率分别为69.77%(60/86)、76.74%(66/86),TVUS+MRI的诊断准确率为89.53%(77/86);TVUS+MRI对宫颈癌分期的诊断准确率高于TVUS、MRI单独检查,差异有统计学意义(P<0.05)。TVUS+MRI对宫颈癌T分期中的基质带浸润、长径<2 cm小病灶、阴道侵犯及宫旁浸润的检出率分别为88.46%、88.00%、91.18%、96.88%,均高于TVUS单独检查的73.08%、60.00%、70.59%、78.13%和MRI单独检查的71.15%、64.00%、64.71%、81.25%,差异有统计学意义(P<0.05)。TVUS+MRI与手术病理分期结果的一致性较强(Kappa=0.823)。结论TVUS联合MRI能明显提高早期宫颈癌术前分期的诊断准确率,且与手术病理分期的一致性较强,可为临床制定治疗方案提供可靠依据。

动态增强MRI和超声3D-TVS技术在子宫内膜癌分期诊断中的对比研究

目的:分析动态增强磁共振成像(DCE-MRI)和经阴道三维超声(3D-TVS)技术在子宫内膜癌(EC)Ⅰ~Ⅳ分期诊断中的对比。方法:选取医院妇科收治的96例EC患者,均通过病理检查确诊,且术前均行DCE-MRI和3D-TVS检查,记录并比较两种检查技术诊断EC患者分期的检查结果,采用受试者工作特征(ROC)曲线,分析DCE-MRI和3D-TVS技术在子宫内膜癌Ⅰ~Ⅳ分期诊断的价值。结果:96例EC患者国际妇产科联盟(FIGO)标准中Ⅰ期50例,Ⅱ期29例,Ⅲ期11例,Ⅳ期6例。病理结果中子宫内膜样腺癌85例(占88.54%),乳头状腺癌2例(占2.08%),透明细胞癌4例(占4.17%),腺鳞癌5例(占5.21%);肿瘤分化程度中高分化31例(占32.29%),中分化52例(占54.17%),低分化或未分化13例(占13.54%)。DCE-MRI检查不同病理分期容积转运常数(K^(trans))、速率常数(K_(ep))及血管外细胞外容积分数(Ve)水平明显升高,各分期间比较差异有统计学意义(F=51.570,F=12.510,F=22.410;P<0.05);DCE-MRI诊断EC患者总检出率为72.92%。3D-TVS检查不同病理分期子宫体积及肿瘤体积水平明显升高,各分期间比较差异有统计学意义(Z=-2.165,Z=-2.134;P<0.05);3D-TVS诊断EC患者总检出率为77.08%。ROC曲线分析结果,MRI和3D-TVS诊断EC患者分期的曲线下面积(AUC)分别为0.715和0.756。结论:DCE-MRI和3D-TVS技术均可诊断子宫内膜癌各分期,其中3D-TVS技术准确度较高,可更好的指导临床治疗。

TVS和CEUS诊断子宫内膜良恶性病变的价值

本次研究的目的是探讨子宫内膜良恶性病变中,经阴道超声检查(TVS)和超声造影(CEUS)的鉴别诊断价值。选取确诊的子宫内膜病变患者108例,给予TVS和CEUS检查。经病理学检查,恶性病变60例,良性病变48例;CEUS诊断子宫内膜良恶性病变的灵敏性、准确性和阴性预测值明显高于TVS检查(P<0.05);恶性病变和良性病变阻力指数(RI)、达峰时间(TTP)与峰值强度(Peak)有明显差异(P<0.05);Ⅲ~Ⅳ和Ⅰ~Ⅱ期RI、TTP和Peak有明显差异(P<0.05);RI、Peak和TTP诊断子宫内膜恶性病变的ROC曲线下面积分别为0.740、0.789和0.856,P<0.05。相比较TVS,CEUS鉴别诊断子宫内膜良恶性疾病有较好的价值,值得临床应用。

TVS联合实时剪切波弹性成像对剖宫产术后SP再次分娩方式的预测

目的:研究经阴道超声检查(Transvaginal Ultrasonography,TVS)联合实时剪切波弹性成像对剖宫产术后瘢痕子宫妊娠(scar pregnancy,SP)再次分娩方式的预测价值。方法:选取2017年10月至2020年10月在我院就诊的剖宫产术后SP再次妊娠患者105例,所有患者先采用Voluson730超声诊断仪进行TVS检查,再采用Mindray Resona 7超声诊断仪进行实时剪切波弹性成像检查,观察患者子宫下段肌层厚度。统计瘢痕分级、分娩结局、弹性评分。结果:与TVS检查相比,TVS联合实时剪切波弹性成像检测患者瘢痕显影率较高100.00%(105/105)(P<0.05)。两项联合检测患者瘢痕分级Ⅰ级79例,Ⅱ级16例,Ⅲ级7例,Ⅳ级3例。随着患者瘢痕分级增加,子宫前壁下段肌层厚度逐渐下降,剖宫产术中出血量增加(P<0.05)。与瘢痕分级Ⅰ级相比,Ⅱ级、Ⅲ级、Ⅳ级患者剖宫产率,阴道分娩率较低;与瘢痕分级Ⅱ级相比,Ⅲ级、Ⅳ级患者剖宫产率,阴道分娩率较低(P<0.05)。与剖宫产相比,阴道分娩患者无3分弹性评分,1分弹性评分较高,2分弹性评分较低(P<0.05)。结论:经阴道TVS联合实时剪切波弹性成像能提高患者子宫瘢痕显影状况,在检查其子宫前壁下段肌层厚度方面具有优势,两项联合对剖宫产术后SP再次分娩方式选择有一定的预测价值。

经阴道彩色多普勒超声(TVS)对宫内残留物的诊断价值

目的探讨经阴道彩色多普勒超声(TVS)检查在诊断宫腔内残留组织的临床应用价值。方法将136例临床怀疑宫内组织残留者行经阴道彩色多普勒超声(TVS)检查,观察子宫的大小形态、宫内残留物残留范围及血流情况。结果经阴道彩色多普勒超声(TVS)诊断结果与清宫术后病理检查结果相对照,诊断符合率为97.8%(133/136),误诊率为2.2%(3/136)。结论经阴道彩色多普勒(TVS)超声检查可以准确诊断子宫腔内组织的残留,还可以为临床医师的正确处理提供明确的部位。