不同超声联合诊断在不同严重程度宫腔粘连中的应用

目的:研究不同超声联合诊断在不同严重程度宫腔粘连中的应用价值(阴道超声、三维超声及能量超声).方法:回顾性分析2018年3月—2020年4月我院收治的63例临床诊断为宫腔粘连已婚妇女.根据宫腔镜检查结果将患者分为宫腔正常对照组及宫腔粘连组,分析两组超声图像特征.并分析阴道超声联合三维超声的准确率.根据宫腔镜检查结果及宫...

Application of different ultrasound based methods in diagnosis of different severity of intrauterine adhesions

Objective:To investigate the value of different ultrasound based methods in diagnosis of different severity of intrauterine adhesions.Methods:Sixty-three cases of married women with intrauterine adhesions treated in our hospital from March 2018 to April 2020 were retrospectively analyzed.Women were divided into two groups according to hysteroscopy results:control group and intrauterine adhesion group,and the ultrasonic image characteristics of two groups were compared.The accuracy of vaginal ultrasound combined with three-dimensional ultrasound was also analyzed.Intrauterine adhesion group was further divided into three groups according to the severity degrees:mild adhesions group,moderate adhesions group and severe adhesions group.The difference of ultrasonic parameters among each group was analyzed.Results:Among the 63 patients,11 had normal uterine cavity and 52 had intrauterine adhesion,including 31 cases of mild adhesion,15 cases of moderate adhesion and 6 cases of severe adhesion.In control group,vaginal ultrasound showed continuous and uniform endometrial echo,and three-dimensional ultrasound showed that uterine cavity was inverted triangle with clear regular boundary.In intrauterine adhesions group:vaginal ultrasound showed thin endometrium,irregular shape,local discontinuous endometrial echo,unclear endometrial line,and unclear boundary between local endometrial line and muscular layer,three dimensional ultrasound showed local echo defects in endometrium.The total accuracy rates of vaginal ultrasound,three-dimensional ultrasound,and Doppler ultrasound in the diagnosis of intrauterine adhesions were 68.25%,77.78%,and 79.37%,respectively,the total accuracy rates of vaginal ultrasound combined with three-dimensional ultrasound,vaginal ultrasound combined with Doppler ultrasound,and three-dimensional ultrasound combined with Doppler ultrasound in the diagnosis of intrauterine adhesions were 77.78%,79.37%,and 82.54%,respectively,49 cases of intrauterine adhesions were confirmed by combined diagnosis,and 48 cases were confirmed by hysteroscopy,including 28 cases of mild adhesion(90.32%),14 cases of moderate adhesion(93.33%),and 6 cases of severe adhesion(100.00%).Four cases were missed diagnosis.The sensitivity,specificity and total accuracy of combined diagnosis were 92.31%,90.91%and 92.06%,respectively.ED,EV,VI and VFI had significant differences among control group,mild group,moderate group and severe group(P<0.05).Conclusion:The combined diagnosis of the three can diagnose intrauterine adhesions more comprehensively,accurately and intuitively,which is helpful to improve the diagnosis rate and has high clinical diagnostic value.