经阴道三维超声对各种子宫疾病的诊断价值

目的]探讨经阴道三维超声（3D-TVS）不同子宫疾病的诊断价值.方法]对874例不同子宫疾病患者的3D-TVS检查结果与宫腔镜（或联合腹腔镜）检查结果进行对比分析,通过计算Kappa值来评价两者诊断的一致性程度.结果]874例患者中,宫腔镜（或联合腹腔镜）检查：子宫畸形者48例,宫腔粘连者114例,宫腔息肉者116例;3D-TVS对子宫畸形的诊断符合率为100％;对轻、中、重度粘连的诊断符合率分别为86.5％（45/52,P＜0.05）、95.8％（46/48,P＜0.05）、100％ （14/14,P＜0.05）;对单发息肉诊断符合率为91.9％（34/37,P＜0.05）,多发息肉诊断符合率为96.2％（76/79,P＜0.05）.结论]3D-TVS成像准确、直观、立体,是一种对子宫疾病诊断可靠的影像学方法.

Value of Three-dimensional Transvaginal Ultrasound in the Diagnosis of Uterine Diseases

Objective]To explore the value of three-dimensional transvaginal ultrasound（3D-TVS） in the diagnosis of uterine diseases.Methods]The results of 3D-TVS of 874 patients with uterine diseases were compared with the results of hysteroscopy or hysteroscopy combined with laparoscopy.Kappa value was calculated to assess the consistency of two examination methods.Results]Among 874 patients,48 patients were uterine malformation,114 patients were intrauterine adhesion and 116 patients were endometrial polyps diagnosed by hysteroscopy or hysteroscopy combined with laparoscopy.The coincidence rate of 3D-TVS in the diagnosis of uterine malformation was 100％.The coincidence rate of 3D-TVS in the diagnosis of slight,moderate and severe intrauterine adhesion was 86.5％（45/52,P ＜0.05）,95.8％（46/48,P ＜0.05） and 100％（14/14,P ＜0.05）,respectively.The coincidence rate of 3D-TVS in the diagnosis of single and multiple endometrial polyps was 91.9％（34/37,P ＜0.05） and 96.2％（76/79,P ＜0.05）,respectively.Conclusion] 3D-TVS imaging is accurate,direct and spatial,so it is regarded as a reliable iconography method.