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目的 探讨宫腔声学造影(SHG)诊断剖宫产术后子宫切口憩室的价值。方法 对剖宫产术后临床怀疑子宫切口憩室的28例患者进行宫腔声学造影检查及常规经阴道超声(TVS)检查,观察并测量憩室大小及肌层厚度,观察对比两种超声检查方法诊断切口憩室的价值。超声检查后均进行宫腔镜检查,并以宫腔镜检查结果作为金标准。结果 宫腔镜检查发现20例子宫切口憩室、宫腔声学造影检查发现20例、常规经阴道超声检查发现17例。以宫腔镜检查结果为金标准,SHG、TVS诊断子宫切口憩室的准确率分别为100%(20/20)、89.29%(17/20)。TVS测量憩室上下径[(9.17±2.63) mm]、左右径[(11.76±5.67) mm]及肌层厚度[(3.29±1.01) mm]与SHG测量结果[上下径:(12.01±4.04) mm、左右径:(12.37±6.14) mm、厚度:(2.85±1.30) mm]差异均有统计学意义(P均<0.05),TVS与宫腔声学造影测量的憩室高度[(5.62±2.13) mm vs (5.50±2.34) mm]差异无统计学意义(P>0.05)。宫腔声学造影还发现宫腔粘连带5例、子宫内膜息肉4例、黏膜下肌瘤1例。结论 宫腔声学造影诊断剖宫产术后子宫切口憩室具有一定的临床价值。 相似文献
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目的探讨育龄期非妊娠期子宫异常出血(AUB)原因分类系统(PALM-COEIN病因分类系统)在AUB患者中的应用价值。方法选择2013年1月至2018年1月到该院就诊AUB患者300例,所有患者均进行宫腔镜检查并按照PALM-COEIN病因分类系统进行病因分类。统计PALM-COEIN病因分类系统下不同类型病因占比;按照AUB患者不同临床表现统计PALM-COEIN病因分类系统分类情况。结果 AUB患者子宫结构异常中子宫内膜息肉占比最高(35.67%),非结构异常中排卵障碍占比最高(44.00%);月经频发、月经过多患者分类均为AUB-P;经期延长/经期不规律患者中子宫内膜增生分类为AUB-O,且占比最高,为72.19%;月经稀少分类均为AUB-O;月经稀发患者中增殖期子宫内膜分类为AUB-O,且占比最高,为88.89%;经间期出血患者中宫内节育器分类为AUB-I,且占比最高,为48.48%。结论通过宫腔镜检测并按照PALM-COEIN病因分类系统分类可有效对AUB患者病因进行分类分析。 相似文献
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子宫内膜腺肌瘤性息肉的诊治分析 总被引:1,自引:0,他引:1
目的探讨宫腔镜诊治子宫内膜腺肌瘤性息肉的临床应用。方法分析42例子宫内膜腺肌瘤性息肉患者的诊治及预后。结果诊断子宫内膜腺肌瘤性息肉的敏感度宫腔镜检查57.14%,B超35.71%,二者差异有显著性(P〈0.05)。误诊为子宫黏膜下肌瘤率宫腔镜检查42.86%,B超47.62%,二者差异无显著性(P〉0.05)。全部患者均行宫腔镜子宫内膜息肉切除术,术后随访1~10年,无任何病例复发。5例非典型息肉样腺肌瘤患者预后良好。结论宫腔镜是诊治子宫内膜腺肌瘤性息肉的最好方法;非典型息肉样腺肌瘤患者,必要时术后辅以高效孕酮治疗。 相似文献
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目的 评估三维超声生理盐水宫腔声学造影(3D-SIS)对子宫黏膜下肌瘤术前分型的临床价值。 方法 选择因不规则阴道出血并经阴道超声检查(TVS)诊断为子宫黏膜下肌瘤的患者62例,用3D-SIS与宫腔镜(HS)检查按照欧洲宫腔镜学会对黏膜下肌瘤的分型标准,分别对子宫黏膜下肌瘤进行分型并与术后分型结果比较。 结果 62例患者共检出子宫黏膜下肌瘤73个,均经手术证实,3D-SIS及HS检查对子宫黏膜下肌瘤分型的一致性分别为:0型100%(13/13);Ⅰ型92.31%(24/26);Ⅱ型82.35%(28/34),总一致性为89.04%(65/73)。 结论 通过术前对子宫黏膜下肌瘤的分型,3D-SIS对选择合适的手术方式具有重要的临床价值。 相似文献
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目的通过比较经阴道超声、宫腔镜诊断与病理学诊断子宫内膜息肉(EMP)的符合情况。分析宫腔镜诊断及治疗EMP的临床效果,了解宫腔镜检杏在诊断EMP方面的优势。方法分析125例经超声诊断为EMP患者的临床表现、宫腔镜诊断及病理学诊断。结果125例患者均行宫腔镜检查,其中宫腔镜诊断为EMP者103例;病理学诊断为EMP者96例。经阴道超声与病理学诊断EMP的符合率为76.8%,宫腔镜检查与病理学诊断EMP的符合率为93.2%。结论宫腔镜检查是确诊EMP安全、有效的方法,与超声、病理学检查相结合,诊断EMP更准确。 相似文献
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宫腔镜诊治子宫内膜息肉临床分析 总被引:4,自引:0,他引:4
目的 分析宫腔镜诊治子宫内膜息肉的临床价值。方法 宫腔镜检查子宫异常出血患者260例,对诊为子宫内膜息肉者行宫腔镜手术,术后加用孕激素治疗。结果260例异常子宫出血患者中,子宫内膜息肉83例,占31.9%,均经病理证实。78例镜检同时进行了治疗,5例择期行电切术,随访6个月~2年,复发5例,治愈率95.2%,无并发症发生。结论 宫腔镜诊断子宫内膜息肉准确率高、创伤小,并能同时进行治疗,疗效肯定。 相似文献
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目的 该研究比较了经阴道超声(transvaginal ultrasonography,TVS)与宫腔镜检查(hysteroscopy,HS)在诊断绝经后服用他莫昔芬(tamoxifen,TAM)对子宫内膜病变的价值,以探讨与其相关的监测方法.方法 随诊了46例绝经后因乳腺癌服用TAM(20mg/d)超过6个月的妇女.所有患者均施行了TVS、HS以及内膜组织病理学检查.TVS以子宫内膜厚度≥5mm为阳性判断标准.结果 TVS检查结果阳性21例(45.7%)中,经HS及病理诊断证实内膜息肉14例,单纯增殖型内膜2例,萎缩型内膜5例;TVS检查结果阴性25例(54.3%)中,内膜息肉8例,单纯增殖型内膜3例,萎缩型内膜14例.TVS检查的特异性为70.8%,敏感性为63.6%,阳性预测值为66.7%,阴性预测值为68.0%.而HS分别为100%、96.0%、95.7%和95.7%.息肉病人的TVS结果与非息肉病人比较差异有显著性(P=0.019).结论 由于TAM对绝经后的子宫内膜具有雌激素样作用,能够引起内膜基质水肿,产生类似增生内膜的超声影像,导致TVS的检查结果与HS下所见以及内膜病检不相符.服用TAM的绝经后乳腺癌患者,单纯以TVS作为其内膜病变的筛选方法具有一定诊断价值,但存在较高的假阳性率且特异性较差.在确诊子宫内膜息肉方面HS具有特殊优势. 相似文献
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Diagnostic accuracy of endometrial thickness to exclude polyps in women with postmenopausal bleeding 总被引:2,自引:0,他引:2
Timmermans A Gerritse MB Opmeer BC Jansen FW Mol BW Veersema S 《Journal of clinical ultrasound : JCU》2008,36(5):286-290
PURPOSE: To determine the accuracy of endometrial thickness measurement with transvaginal ultrasonography (TVUS) to diagnose endometrial polyps in women with postmenopausal bleeding in whom a carcinoma has been ruled out. METHODS: In women with postmenopausal bleeding, endometrial thickness was measured with TVUS. If endometrial thickness was >4 mm, office hysteroscopy was performed. At hysteroscopy, the uterine cavity was assessed for the presence of polyps. Patients with malignancy were excluded. We used receiver operating characteristics (ROC) analysis to assess the capacity of TVUS endometrial thickness measurement to diagnose endometrial polyps. Findings at hysteroscopy were considered to be the reference standard. RESULTS: We included 178 patients with postmenopausal bleeding and endometrial thickness >4 mm. Hysteroscopy showed an endometrial polyp in 90 patients (50%). The ROC analysis revealed that endometrial thickness had an area under the curve of 0.64 in the diagnosis of endometrial polyps. CONCLUSION: In women with postmenopausal bleeding in whom carcinoma has been ruled out, measurement of endometrial thickness with TVUS is not useful in the diagnosis of endometrial polyps. 相似文献
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R Achiron S Lipitz E Sivan M Goldenberg S Mashiach 《Journal of ultrasound in medicine》1995,14(9):685-688
Most menopausal patients with breast cancer receive tamoxifen therapy. In these patients, TVS may show thickened, irregular cystic endometria. For better visualization of these patients' uterine cavities, we performed transvaginal sonohysterography. During vaginal ultrasonography, sterile saline was introduced by transcervical 8 French Foley catheter into the uterine cavity of 20 women who were referred with tamoxifen-associated cystic thickened endometria. In eight women, transvaginal sonohysterography provided the means to diagnose occult, free-floating endometrial polyps, whereas in 12 women, the fluid contrast augmented the diagnosis of an irregular cystic endometrial-myometrial junction. All 20 patients underwent diagnostic hysteroscopy: eight polyps, none of which were malignant, were confirmed and removed by hysteroscopic resection. Of the remaining 12 patients with an irregular endometrial-myometrial junction, endometrial curettage showed no significant pathologic findings. Transvaginal sonohysterography seems to enhance the differentiation between endometrial polyps that should be resected by operative hysteroscopy and an abnormal endometrial-myometrial junction that may benefit from biopsy sampling only. 相似文献
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Botsis D Papagianni V Makrakis E Aravantinos L Creatsas G 《Journal of clinical ultrasound : JCU》2006,34(9):434-439
PURPOSE: To evaluate and compare the accuracy of transvaginal sonography (TVS) and sonohysterography (SHG) in the investigation of women of reproductive age presenting with irregular uterine bleeding (IUB). METHODS: This prospective study included 104 women presenting with IUB. All patients underwent TVS, SHG, and hysteroscopy, during which endometrial biopsies were obtained and any endometrial mass was treated with hysteroscopic surgery. Statistical analysis was performed by calculating the sensitivity, specificity, and positive and negative predictive values of TVS and SHG in diagnosing endometrial polyp, submucous myoma and all endometrial pathologies (polyp, submucous myoma, endometrial hyperplasia, and endometrial carcinoma) with the histopathological report of the tissues obtained by hysteroscopy serving as the end point for the analysis. RESULTS: The sensitivity, specificity, and positive and negative predictive values, respectively of TVS were 61.2%, 90.9%, 85.7%, and 72.5% for diagnosing endometrial polyps; 75.0%, 92.0%, 63.1%, and 95.3% for diagnosing submucous myomas; and 75.0%, 80.6%, 87.9%, and 63.0% for diagnosing any kind of pathology. The corresponding diagnostic values of SHG were 83.7%, 96.4%, 95.3%, and 86.9% for polyps; 87.5%, 98.9%, 93.3%, and 97.8% for submucous myomas; and 88.2%, 91.7%, 95.2%, and 80.5% for any kind of pathology. CONCLUSIONS: SHG showed superior sensitivity, specificity, and positive and negative predictive values compared with TVS in diagnosing intrauterine lesions in women of reproductive age with IUB. 相似文献
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阴道三维超声及子宫造影检查诊断子宫内膜息肉的价值 总被引:2,自引:0,他引:2
目的 观察阴道三维超声检查子宫内膜息肉的影像学特征,探讨本法诊断子宫内膜息肉的价值。方法 阴道三维超声结合官腔注射生理盐水显像检查诊断子宫内膜息肉25例,并全部在官腔镜下切除新生物作病理组织学检查。结果 25例阴道三维超声诊断子宫内膜息肉中有24例与病理组织学符合,符合率为96%。结论 阴道三维超声结合子宫造影是诊断子宫内膜息肉简便可靠的方法。 相似文献