阴道超声和彩色多普勒超声在诊断绝经后宫腔病变中的价值

目的探讨经阴道超声和彩色多普勒超声检查绝经后妇女宫腔内病变的临床意义和应用价值,并与宫腔镜检查作比较。方法选择158例资料完整的绝经妇女作为研究对象,第1组(n=92):有出血史,经阴道超声和彩色多普勒超声检查宫腔内异常;第2组(n=25):无出血史,在体检或治疗其他疾病作阴超检查时发现宫腔内异常;第3组(n=41):有出血史,经宫腔镜检查诊断宫内异常。三组诊断结果均与组织病理学诊断结果进行比较。结果第1、2组阴道超声检查结果共有105例与组织病理学结果一致,符合率为89.7%,误诊率为10.2%;第3组宫腔镜检查符合率为90.2%,误诊率为9.8%,两种检查方法的诊断符合率无统计学差异(P>0.05)。第1组组织病理学结果宫内良性病变63例(73%),恶性病变25例(27%);第2组全部为宫内良性病变,两组比较有显著性差异(P=0.0033)。结论阴道二维超声和彩色多普勒超声作为非侵入性、无痛苦的检测手段,对诊断绝经后妇女宫内异常具有重要的应用价值。

Value of transvaginal ultrasonography and color Doppler ultrasonography in diagnosis of postmenopausal disorders in uterine cavity

Objective To study the clinical significance and application value of transvaginal ultrasonography and color Doppler ultrasonography in detecting postmenopausal disorders in utrine cavity, and make comparison with diagnostic uteroscopy. Methods One hundred and fifty-eight postmenopausal women with complete data were enrolled as study objectives: group 1(n=92), with history of bleeding and disorders of uterine cavity discovered by transvaginal ultrasonography and color Doppler ultrasonography; group 2(n=25), without history of bleeding while with disorders of uterine cavity discovered by transvaginal ultrasonography during physical examination or treatment of other diseases; group 3(n=41), with history of bleeding and disorders of uterine cavity discovered by uteroscopy. The diagnostic results were compared with the pathological findings. Results The results of 105 patients revealed by transvaginal ultrasonography were in line with the pathological findings in group 1 and 2, with the coincidence rate of 89.7% and misdiagnosis rate of 10.2%. While the coincidence rate and misdiagnosis rate of uteroscopy in group 3 were 90.2% and 9.8%, respectively. There was no significant difference in the coincidence rate between the two diagnosis methods(P>0.05). The pathological findings indicated benign lesions in 63 patients(73%) and malignant lesions in 25 patients(27%)in group 1. All the lesions were found benign in group 2. There was significant difference between the two groups(P=0.0033). Conclusion Noninvasive and painless transvaginal two-dimensional ultrasonograpy and color Doppler ultrasonography may have important clinical application value in diagnosis of intrauterine anomaly in post-menopausal women.