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目的:探讨经阴道实时三维超声诊断子宫异常出血的价值。方法:回顾分析我院因子宫异常出血行宫腔镜检查患者300例分别行术前二维阴道彩超检查(二维组,150例)和实时三维阴道彩超检查(三维组,150例)的资料,将两组患者检查结果与宫腔镜手术病理结果进行比较。结果:二维组发现宫内病变包括子宫内膜息肉、黏膜下肌瘤、子宫内膜生子宫内膜癌75例,宫腔镜发现宫腔内病变88例;三维组发现宫腔内病变包括子宫内膜息肉、黏膜下肌瘤、子宫内膜增生、子宫内膜癌85例,宫腔镜发现宫腔内病变88例。三维组与宫腔镜病理结果比较,敏感度为94.3%,阴性预测值92.3%,漏诊率5.6%,诊断符合率95.3%;二维组与宫腔镜病理结果比较,敏感度为82.9%,阴性预测值80.0%,漏诊率17.0%,诊断符合率88.6%。两组比较差异有统计学意义(P<0.05)。结论:经阴道实时三维超声诊断宫腔内病变致子宫异常出血要优于二维超声。
Objective: To investigate the value of transvaginal real-time three-dimensional sonography in the diagnosis of abnormal uterine bleeding. Methods: The retrospective analysis of 300 cases of hysteroscopy due to abnormal uterine bleeding in our hospital were performed preoperative two-dimensional vaginal ultrasound examination (two-dimensional group, 150 cases) and real-time three-dimensional vaginal ultrasound examination (three-dimensional group, 150 cases) The results of two groups of patients and hysteroscopic surgery were compared. Results: Two-dimensional group found intrauterine lesions including endometrial polyps, submucosal fibroids, endometrial endometrial cancer in 75 cases, hysteroscopy found intrauterine lesions in 88 cases; three-dimensional group found intrauterine lesions including Endometrial polyps, submucosal fibroids, endometrial hyperplasia, endometrial cancer in 85 cases, hysteroscopy found intrauterine lesions in 88 cases. Three-dimensional group and hysteroscopic pathological results, the sensitivity was 94.3%, the negative predictive value of 92.3%, missed diagnosis rate of 5.6%, the diagnostic coincidence rate of 95.3%; two-dimensional group and hysteroscopic pathological results, the sensitivity was 82.9% The negative predictive value was 80.0%, the misdiagnosis rate was 17.0%, and the diagnostic coincidence rate was 88.6%. The difference between the two groups was statistically significant (P <0.05). Conclusion: Transvaginal real-time three-dimensional ultrasound diagnosis of intrauterine lesions caused by abnormal uterine bleeding is better than two-dimensional ultrasound.