经阴道超声诊断不孕妇女子宫内膜息肉及其相关疾病分析

目的:探讨不孕妇女子宫内膜息肉(EP)声像图特征及与可能伴发高发生率的盆腔疾病的关系。方法:回顾性分析2003年6月~2005年6月腹腔镜术前经阴道超声(TVS)检查疑有EP的116例不孕患者,经宫腔镜术及病理检查证实EP的超声声像图,同时分析经腹腔镜证实伴发的高发生率的盆腔疾病。结果:116例患者经宫腔镜和病理证实EP94例,符合率为81.03%(94/116),误诊率为18.97%(22/116)。EP声像图主要表现为子宫腔内高或等回声团块,团块所在部位宫腔线弯曲、中断或消失;部份内膜呈不均匀高回声,宫腔线未能清晰显示,误诊的22例病理结果为内膜单纯性增生过长、增殖期及分泌期子宫内膜。经宫腔镜和病理证实的EP患者腹腔镜术中发现伴发有较高的子宫内膜异位症,其发生率为53.19%(50/94)。结论:TVS诊断EP声像图有一定的特征性,但易与内膜增长过长等混淆,须结合宫腔镜和病理检查提高诊断符合率;有子宫内膜息肉的不孕妇女有高发子宫内膜异位症的可能性。

Analysis of Endometrial Polyps and Relevant Diseases Diagnosed by Transvaginal Ultrasonography in Infertile Women

Objective: To investigate the retationship between ultrasonography imaging of endometrial polyps (EP) and the high incidence of its relevant diseases. Methods: 116 cases of ultrasonography imaging of EP were analysed in infertile women who were uncertainly diagnosed to EP by transvaginal ultrasonography (TVS), which were confirmed with high incidence of pelvic complication by hysteroscopy and pathology examination from June 2003 to the same month of 2005. Results: Of all, 94 infertile women were confirmed by hysteroscopy and pathology examination. And the accuracy rate was 81.03%(94/116), the misdiagnosis rate was 18.97% (22/116). The ultrasonography imaging of EP presented caruncle with high echo in cavity; and cavity line on the site of caruncle was irregular,discontinuity or disappeared; or part of endometrium appeared uneven high echo and unclear lines. 22 cases of misdiagnosed EP presented hyperplasia, proliferative phase and secretory phase endometria. There was high incidence (53.19%) of endometriosis diagnosed by laparoscopy among all patients. Conclusion: TVS is certainly a particular examination instrument in diagnosing EP,but it tends to misdiagnose to endometrial hyperplasia. It can improve accuracy to combine TVS with hysteroscopy and pathology examination. There is higher incidence of endometriosis complication in these infertile women who are suffered from EP.