经阴道超声对子宫内膜疾病的诊断价值

目的探讨经阴道超声对子宫内膜疾病的诊断价值。方法回顾分析86例妇女(绝经前50例,绝经后36例)经腹及经阴道超声检查结果并与子宫内膜病理对照。结果内膜活检的病理分类有内膜癌、内膜息肉、内膜增生过长等,其超声表现以内膜增厚为主,多伴内膜回声增强、不均或宫腔内混合回声。经腹超声(TAS)和经阴道超声(TVS)诊断子宫内膜疾病诊断符合率分别为70.9％及91．8％。结论经阴道超声诊断子宫内膜病变与经腹超声相比有明显的优势,有重要的临床应用价值。     

超声检查诊断子宫内膜病变的临床价值

目的探讨超声检查诊断子宫内膜病变的临床价值。 方法对105例（绝经后65例）阴道不规则流血或排液妇女的盆腔行经腹部或经阴道超声检查,重点观察子宫内膜情况。经手术治疗79例,刮宫26例,将超声与手术或刮宫的病理结果相对照。 结果子宫内膜癌超声表现为内膜增厚、回声不均、部分病灶凸向宫腔伴积液,52例中46例与病理诊断符合;内膜息肉多为宫腔内中强回声团,18例中16例符合;内膜增生以内膜增厚为主,20例中18例符合;黏膜下肌瘤回声减低通常见蒂,15例中12例符合。 结论经腹与经阴道超声检查联合应用对子宫内膜病变的诊断具有较高的价值。     

经阴道彩色多普勒超声检测子宫内膜病变65例分析

目的：探讨经阴道彩色多普勒超声诊断子宫内膜病变的临床价值。方法：回顾性分析65例经阴道彩色多普勒超声（TVCD）诊断子宫内膜病变患者子宫内膜二维声像图特征，并与子宫内膜诊刮病理对照。结果：65例妇女子宫内膜诊刮病理分类有子宫内膜癌、子宫内膜息肉、子宫黏膜下肌瘤、子宫内膜增生过长，其超声声像图表现以内膜增厚为主，多伴内膜回声增强，不均或官腔内混合回声，经阴道超声诊断子宫内膜疾病诊断符合率为93．3％。结论：TVCD是一种有效的诊断及鉴别诊断子宫内膜病变的检查方法。     

阴道超声和宫腔镜检查在绝经后子宫内膜病变中诊断价值

目的：探讨阴道超声和宫腔镜检查诊断绝经后子宫内膜病变的临床价值。方法：160例绝经后子宫内膜病变患者行阴道超声及宫腔镜检查;以病理结果为标准,评价阴道超声和宫腔镜检查对诊断子宫内膜病变的敏感性、特异性、阳性预测值及阴性预测值。结果：经阴道超声检查48例正常,其中40例病理证实子宫内膜无异常;112例诊断为宫腔病变,其中96例经病理证实。宫腔镜检查52例正常,其中1例病理证实为子宫内膜单纯型增生;108例诊断为宫腔病变,其中103例经病理证实。宫腔镜检查宫腔内病变、子宫内膜癌和癌前病变的特异性、阳性预测值均高于经阴道超声检查(P＜0.05).结论：经阴道超声检查是一种筛查子宫内膜病变较好的方法;阴道超声联合宫腔镜检查对诊断绝经后子宫内膜病变有重要价值。     

经腹和经阴道彩色多普勒超声诊断绝经后子宫内膜病变的比较

【目的】探讨彩色多普勒超声检查绝经后阴道流血患者子宫内膜病变的价值。【方法】比较经腹及经阴道超声检查绝经后阴道流血患者的子宫内膜病变的影像特点,重点观察子宫内膜的厚度,血流分布情况,阻力指数(RI)值。【结果】所有患者均经诊刮有病理结果,不同的子宫内膜病变均有其声像特征。但经阴道彩色多普勒检查内膜病变的病理诊断符合率明显优于经腹彩色多普勒检查。【结论】经阴道彩色多普勒对绝经后妇女子宫内膜出血的病因诊断有重要的临床应用价值。     

超声检测绝经后子宫内膜的临床价值

Ｂ型超声诊断子宫附件疾患早已成为妇产科领域广泛应用的方法。本研究对 5 6例绝经后妇女子宫内膜的超声表现与病理结果进行比较 ,进一步探讨超声诊断绝经后子宫内膜病变的临床价值。资料与方法选择我院自 1996年 1月以来共 4年间就诊的绝经后妇女5 6例 ,年龄 45～ 70岁 ,平均 5 8岁 ,临床表现均为绝经后阴道出血 ,量多少不等。用ＳＩＥＭＥＮＳＳＩ40 0型超声诊断仪 ,探头频率3 .5ＭＨｚ ,在膀胱适度充盈情况下 ,作盆腔常规扫查 ,测量子宫大小 (长、厚、宽及长径到宫颈内口的距离 ) ,重点观察子宫内膜回声。根据超声图像特征 ,将内膜回声分…     

经阴道超声对绝经后子宫腔内病变的鉴别诊断价值

经阴道超声是绝经后妇女阴道出血的首选检查方法，并把子宫双层内膜厚度≥5mm或6mm作为筛查子宫内膜病变的临界点已被大多数学者公认。但要进一步鉴别内膜息肉、内膜增生、内膜癌等内膜病变仍有一定困难。本研究分析绝经后宫腔内病变的超声特征，并与病理结果进行对照，以提高经阴道超声对绝经后宫腔内病变的诊断价值。     

经阴道超声对绝经后子宫内膜病变的诊断价值

应用经阴道超声检查观察105例绝经后阴道出血患者的子宫大小、子宫内膜厚度及其特点，并与诊刮的病理结果进行对照．以探讨经阴道超声对绝经后阴道出血患者子宫内膜病变的诊断价值。     

经阴道彩色多普勒超声诊断子宫内膜病变

目的 探讨经阴道彩色多普勒超声(TV-CDU)诊断子宫内膜病变的价值.方法 对经诊断性刮宫术后病理证实的54例子宫内膜病变患者的TV-CDU声像图进行回顾性分析,并与病理结果对照.结果 54例患者子宫内膜诊断性刮宫术后病理分类包括子宫内膜癌4例、子宫内膜息肉8例、子宫内膜炎5例、单纯性子宫内膜增生过长37例,超声声像图表现以内膜增厚为主,多伴内膜回声增强、不均或宫腔内混合回声.以病理结果为标准,TV-CDU诊断子宫内膜疾病的符合率为81.48%.结论 TV-CDU对于子宫内膜病变的鉴别诊断具有较高的价值,超声检查时应注意测量子宫内膜厚度,观察内膜回声特点、内膜形态、内膜与肌层的关系、内膜内血流情况及阻力指数.     

子宫内膜病变患者经阴道超声诊断价值探讨

目的：探讨经阴道超声技术诊断子宫内膜病变的临床应用价值。方法：选取2020年1月—2021年12月常熟市第二人民医院接诊的子宫内膜病变患者80例进行研究,所有患者均接受经阴道超声检查,以临床综合诊断及病理结果为金标准,统计经阴道超声诊断不同子宫内膜病变的准确率,根据病理结果计算经阴道超声诊断子宫内膜癌疾病的敏感度与特异度。总结不同类型子宫内膜病变患者超声影像表现。结果：通过临床综合诊断及病理结果显示,80例子宫内膜病变患者中,23例确诊为子宫内膜增生,25例确诊为内膜息肉,13例确诊为子宫黏膜下肌瘤,19例患者确诊为子宫内膜癌。经阴道超声诊断准确率与临床综合诊断及病理结果比较差异无统计学意义（P>0.05）。经阴道超声诊断子宫内膜癌的敏感度为84.21%,特异度为96.72%。结论：临床可利用经阴道超声技术鉴别诊断子宫内膜病变,具有较高准确率、敏感度与特异度,能够提供可靠影像支持,倡导运用推广。     

Comparative study of transvaginal sonography and hysteroscopy for the detection of pathologic endometrial lesions in women with postmenopausal bleeding.

Dilatation and curettage is used as the "gold standard" for diagnosing pathologic endometrial lesions in women with postmenopausal bleeding. In this group of women, about 10% have an endometrial cancer and an additional 20% have some other endometrial abnormality. However, some abnormalities, such as endometrial polyps and submucous fibroids, are difficult to diagnose by dilatation and curettage. In such cases, combining transvaginal sonography with hysteroscopy may be of value. This study compared the use of transvaginal sonography and hysteroscopy for evaluation of the uterine cavity in women with postmenopausal bleeding. The study included 51 women, 39 of whom had an abnormally thick ( > 4 mm) endometrium as measured by transvaginal sonography, and 35 of 39 had an abnormal appearance at hysteroscopy. The sensitivity and specificity for the measurement of endometrial thickness using transvaginal sonography to diagnose an endometrial abnormality were 100% and 75%, respectively. The corresponding figures for hysteroscopy were 97% and 88%. In all women with an endometrial thickness of 8 mm as measured by transvaginal sonography, hysteroscopy is identified as an abnormality. The study indicates that transvaginal sonography reveals an endometrial thickness of > or = 8 mm and the histopathologic diagnosis after dilatation and curettage is atrophic endometrial polyp or submucous myoma.     

宫腹腔镜联合治疗不孕症的疗效研究

目的：研究接受宫腹腔镜治疗不孕症患者的病因和疗效,总结宫腹腔镜对不孕症的治疗效果及联合治疗优势。方法：对宫腹腔镜联合治疗的510例不孕症患者临床资料进行分析。结果：510例患者盆腔病变451例,宫腔病变287例;盆腔粘连（51.37%）、子宫内膜异位症（19.02%）和多囊卵巢综合征（10.39%）是盆腔主要病变;子宫内膜异常（16.86%）、宫颈或宫腔良性肿瘤（13.14%）是宫腔主要病变。腹腔镜下输卵管通液术与术前HSG符合率50.97%。510例患者随访率75.49%,受孕214例,受孕率55.58%,试管婴儿43例,占受孕人数20.09%。结论：宫腹腔镜联合对因炎症引起的输卵管源性不孕症治疗效果显著,患者的受孕率跟术后盆腔、宫腔病变治疗效果及输卵管通畅程度有关。     

经阴道超声与宫腔镜检查诊断绝经后服用他莫昔芬妇女子宫内膜病变的比较

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.     

异位子宫内膜维甲酸依赖的17β-HSD2表达异常初探

目的 探讨异位子宫内膜中维甲酸(RA)代谢与17β-羟基类固醇脱氢酶2(17β HSD2)的关系与可能的病理机制.方法 采用免疫组织化学方法,检测22例分泌期子宫内膜异位症患者异位子宫内膜组织和在位内膜组织以及21例正常分泌期子宫内膜中17β HSD2、RARα、RXRα、Sp1、Sp3的表达.结果 正常对照组和在位内膜组的5种蛋白阳性表达率差异均无统计学意义(P>0 05),正常对照组与异位内膜组的5中蛋白阳性表达率差异均有统计学意义(P<0 05).结论 子宫内膜可能通过RA与RARα、RXRα、Sp1、Sp3结合,诱导17β HSD2的表达,并且异位内膜RA代谢异常是17β HSD2基因无表达或弱表达的重要病理机制之一.     

Transvaginal sonography of the uterine cavity with hysteroscopic correlation in the investigation of infertility.

This report describes the correlation of hysteroscopic findings with preoperative transvaginal sonography in 200 patients being investigated for infertility. Real-time ultrasound examination was performed on days 7, 14 and 21 in spontaneous ovulatory cycles. Diagnostic hysteroscopy was performed in the subsequent cycle. The abnormalities detected using transvaginal sonography were intrauterine adhesions, submucous fibroids, endometrial polyps, endometritis and a non-specific irregular endometrium. A total of 182 patients were diagnosed correctly to have an abnormality by transvaginal sonography giving a false-positive rate of 5.5%. The sensitivity of transvaginal sonography in detecting endometrial pathology was 98.9% with a positive predictive value of 94.3%. The positive predictive values for specific abnormalities were 98.5% for intrauterine adhesions, 91.7% for submucous fibroids, 91.4% for endometrial polyps, 85.7% for endometritis and 85.7% for irregular endometrium. These data show a strong correlation between findings from transvaginal sonography and hysteroscopy. Transvaginal sonography may be used to detect intrauterine pathology and identify patients in whom hysteroscopy and hysteroscopic surgery are indicated.     

The significance of endometrial filling defects detected on routine transvaginal sonography.

The objective of this study was to compare endometrial filling defects detected on transvaginal sonography performed without distending media with findings on hysterosalpingography. Forty-three infertile patients were studied in the follicular phrase. Of these, 17 patients had endometrial contour abnormalities detected on vaginal sonogram and 26 patients had no filling defects on ultrasonography. Ultrasonography of the endometrium and hysterosalpingography were performed on all patients as part of a routine workup for infertility. Patients with contour abnormalities detected on either hysterosalpingography or transvaginal ultrasonography underwent hysteroscopy. When a contour abnormality was detected on vaginal sonogram, hysterosalpingography confirmed a defect in 94% of the cases and hysteroscopy in 100% of the cases. Seven of 26 subjects (27%) with normal vaginal ultrasonograms had abnormal hysterosalpingograms; however, only two patients with a normal sonogram had abnormal hysteroscopic findings. Filling defects seen on hysterosalpingography that were not detected on sonography include synechiae, and cornual polyps. This study indicates that vaginal ultrasonography is an accurate tool in the identification of submucous fibroids and polyps. If the examination is performed in the follicular phase, use of distending medium is not necessary to detect major abnormalities of the endometrium. Synechiae are not, however, visible without distention of the endometrial cavity.     

超声无菌生理盐水造影诊断子宫病变及阴道畸形

目的评价超声无菌生理盐水造影诊断子宫病变及阴道畸形的价值。方法向宫腔内或阴道内插入造影导管,注入无菌生理盐水,经阴道超声观察子宫腔、内膜或阴道结构,并与术后病理及随访结果对比分析。结果共观察73例患者,其中子宫内膜息肉35例;子宫颈息肉1例;黏膜下肌瘤4例;子宫内膜增生7例;宫腔粘连2例;宫颈粘连2例,阴道不全纵隔1例;阴道上段完全横隔1例;药物流产后胚胎少量残留5例;未见明显异常者11例;插管未成功4例。超声造影诊断与病理诊断或术中所见符合率100%(62/62)。结论超声无菌生理盐水子宫腔、阴道造影有助于宫腔内病变及阴道畸形的诊断。     

Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women.

OBJECTIVE: To compare the diagnostic accuracy of transvaginal sonography (TVS) and saline infusion sonography (SIS) for detecting intracavitary abnormalities in premenopausal women with abnormal uterine bleeding. METHOD: Consecutive premenopausal women who underwent hysterectomy for abnormal uterine bleeding were included. All women underwent TVS and SIS before their hysterectomy. The findings at TVS and SIS were compared with the findings of the hysterectomy specimen. Sensitivity, specificity, and likelihood ratios were calculated. RESULTS: The results of 50 patients with abnormal uterine bleeding were evaluated. Histological examination revealed normal endometrial histology in 27 patients, submucous myomas in 13 patients and intracavitary polyps in 10 patients. The sensitivity of TVS in directly visualizing intracavitary abnormalities was 61% for a specificity of 96%. The likelihood ratio of presence of an intracavitary abnormality was 16 and the likelihood ratio of absence of such a finding was 0.41. When defining abnormality at TVS as direct visualization of an intracavitary abnormality or an increased endometrial thickness (cut-off level 5 mm), the sensitivity of TVS was 87% for a specificity of 56%, with corresponding likelihood ratios of 2 and 0.23, respectively. The sensitivity and specificity of SIS was 100% and 85% with likelihood ratios of 6 and 0.0, respectively. No intracavitary abnormality was missed by SIS. CONCLUSION: The diagnostic accuracy of SIS is higher than the accuracy of TVS. A combined approach using endometrial thickness measurement by TVS and, reserving SIS for patients with increased (> 5 mm) endometrial thickness, or endometrium inadequately visualized on TVS, is the optimal method of reducing the hysteroscopy rate.     

经阴道超声组织定征诊断子宫内膜癌的探讨

目的对子宫内膜癌妇女和正常妇女的子宫内膜及肌层声像图回声强度定量分析，为超声诊断子宫内膜异常提供客观检测指标。方法超声诊断仪与B型超声图像定量分析仪连机，对18例患子宫内膜癌妇女和38例正常妇女的子宫内膜进行定量测定，比较两组间灰阶强度及分贝的差异。结果子宫内膜癌组内膜灰阶强度及分贝均高于正常组。结论超声组织定征对诊断子宫内膜癌有一定指导意义。