经阴道三维超声在宫腔粘连诊断中的临床意义探讨

目的：对比经腹、阴道二维三维超声诊断宫腔粘连(intrauterine adhesions,IUA)效用,总结诊断价值。方法方便选取以2014年2月-2016年7月医院临床疑似IUA的的女性作为研究对象,入选对象176例,进行经腹、阴道二维三维超声诊断,最终采用宫腔镜诊断确诊,描述统计影像学特征,对比经腹、阴道超声诊断效用指标。结果经阴道三维超声敏感度、特异度、阳性预测值、阴性预测值、符合率分别为80.60%、88.10%、95.58%、58.73%、82.39%,经阴道二维超声、经阴道三维超声敏感度、特异度阳性预测值、阴性预测值、符合率高于经腹超声,经阴道三维超声特异度、阴性预测值、符合率高于经阴二维超声,差异具有统计学意义(P<0.05)；三维超声误漏诊31例,其中漏诊26例。结论经阴道三维超声诊断宫腔粘连诊断效用高,但也可能会因子宫显示不全等原因出现误漏诊。

To Clinical Significance of Transvaginal Three Dimensional Ultrasound in Diagnosis of Intrauterine Adhesions

Objective Contrast abdominal, transvaginal three-dimensional ultrasound in the diagnosis of intrauterine adhe-sions, IUA) utility, summarized the diagnostic value. Methods Convenient selection February 2014 to July 2016, hospital clinical suspected IUA of women as the object of study selected 176 cases, abdominal, transvaginal three-dimensional ultra-sonography in the diagnosis of, in the end, the hysteroscopic diagnosis, to comparison of abdominal and vaginal ultrasound diagnostic utility indicators. Results By three-dimensional transvaginal ultrasound sensitivity, specificity, positive predictive value, negative predictive value, the coincidence rate were 80.60%, 88.10%, 95.58% and 58.73%, 82.39%, transvaginal two-dimensional ultrasound, transvaginal three-dimensional ultrasound sensitivity, specificity, positive predictive value, negative predictive value, with rate than transabdominal ultrasound, the specificity of three-dimensional transvaginal ultra-sound, negative predictive value, with rate than transvaginal two-dimensional ultrasound, the difference has statistical signif-icance (P< 0.05); three dimensional ultrasound misdiagnosis and missed diagnosis in 31 cases, the missed diagnosis of 26 cases. Conclusion The vagina three dimensional ultrasound diagnosis of uterine cavity adhesion diagnostic utility of high, but may due to the uterus showed incomplete reasons of misdiagnosis.