【摘要】 目的:探讨超声检查在宫腔粘连诊断中的价值,寻找简单易行的利于门诊开展的筛查宫腔粘连的技术。方法:对临床疑诊为宫腔粘连的68例患者进行超声检查及宫腔镜检查。将超声诊断结果与宫腔镜诊断结果进行对比分析,用SPSS软件进行数据处理,计算各项统计指标,评估其诊断价值。同时结合宫腔镜检查结果分析宫腔粘连的影像学特点。结果:二维超声及三维超声用于诊断宫腔粘连的各项统计学指标分别为:敏感度65%、90%,特异度100%、100%,阳性预测值100%、100%,阴性预测值28%、57%,约登指数0.65、0.90,Kappa值0.30、0.68。对不同程度宫腔粘连的超声诊断与宫腔镜结果比较,二维超声Kappa为0.50(Z=4.41,P<0.01),三维超声Kappa为0.35(Z=3.60,P<0.01)。结论:超声检查可用于宫腔粘连的诊断,三维超声较二维超声有更高的诊断价值,但超声检查仍存在一定程度的漏诊率及误诊率,宫腔镜检查可进一步明确诊断。推荐超声检查用于宫腔镜手术前的筛查,宫腔粘连超声影像特征图像可为宫腔镜手术提供有效参考。更多还原

【Abstract】 Objective:To evaluate the application of ultrasound in diagnosis of intrauterine adhesions,so as to find a simple and practicable method for the intrauterine adhesion screening. Methods:Ultrasound and hysteroscopy were performed in 68 cases of the intrauterine adhesions suspected clinically. The diagnosis results were compared with the SPSS software,to evaluate their diagnostic values. The imaging features of intrauterine adhesions,together with hysteroscopic observation,were analyzed. Results:The imaging characteristics of two-dimensional ultrasound and three-dimensional ultrasound in diagnosing intrauterine adhesions were included:sensitivity(65%,90%),specificity(100%,100%),the positive predictive value(100%,100%),the negative predictive value(28%,57%),Jorden index(0.65,0.90),Kappa(0.30,0.68). Compared with the hysteroscopy,both two-dimensional ultrasound Kappa=0.50(Z=4.41,P<0.01) and three-dimensional ultrasound Kappa=0.35(Z=3.60,P<0.01) were feasible in diagnosis of different degrees of intrauterine adhesions. Conclusions:Ultrasonography can be used in diagnosis of intrauterine adhesions. Compared with two-dimensional ultrasound,three-dimensional ultrasound has higher diagnostic value. However,ultrasonography still has the missed diagnosis rate and the misdiagnosis rate on some degrees. Hysteroscopy can clarify a diagnosis. Ultrasound,as a noninvasive and relatively simple method,should be recommended as the intrauterine adhesions screening before hysteroscopy.Ultrasonography may provide an effective reference for hysteroscopic surgery.更多还原