经阴道超声与腹腔镜检查在附件包块患者诊治中的诊断准确性比较。
Comparison of diagnostic accuracy of transvaginal ultrasound with laparoscopy in the management of patients with adnexal masses.
机构信息
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Arch Gynecol Obstet. 2009 Nov;280(5):767-73. doi: 10.1007/s00404-009-1001-8. Epub 2009 Mar 5.
PURPOSE
The aims of this study was (a) to compare the diagnostic accuracy of ultrasound examination with laparoscopic findings and both with the gold standard (histology) in the management of benign ovarian lesions, and (b) to assess the feasibility of laparoscopy in their diagnosis and management.
METHODS
Prospective, comparative study (Canadian Task Force Classification II-2). A total of 117 women 15-59 years old were examined at outpatient department and had transvaginal ultrasound assessment. Ninety-eight women (three postmenopausal) with 105 cystic ovarian lesions met inclusion criteria and underwent operative laparoscopy. Histology was performed in all cases.
RESULTS
Although laparoscopy showed an overall higher performance compared to transvaginal ultrasound, statistically significant difference was found only in the detection of endometriomas compared to ultrasound (P = 0.004 for sensitivity and P = 0.046 for specificity).
CONCLUSION
Laparoscopy exhibits higher diagnostic accuracy, especially in endometriomas, compared to transvaginal scan. Laparoscopic diagnosis appears to be safe and accurate. Conservative laparoscopic management of benign adnexal masses is safe and with low morbidity.
目的
本研究旨在（a）比较超声检查与腹腔镜检查以及两者与金标准（组织学）在良性卵巢病变治疗中的诊断准确性，（b）评估腹腔镜检查在其诊断和治疗中的可行性。
方法
前瞻性、对照研究（加拿大任务组分类 II-2）。共有 117 名 15-59 岁的妇女在门诊部进行了经阴道超声评估。符合纳入标准的 98 名（3 名绝经后）妇女有 105 个囊性卵巢病变，并接受了手术腹腔镜检查。所有病例均行组织学检查。
结果
尽管腹腔镜检查总体上比经阴道超声显示出更高的性能，但仅在检测子宫内膜异位症方面与超声检查有统计学显著差异（敏感性为 P = 0.004，特异性为 P = 0.046）。
结论
与经阴道超声相比，腹腔镜检查显示出更高的诊断准确性，尤其是在子宫内膜异位症方面。腹腔镜诊断似乎是安全且准确的。良性附件肿块的保守性腹腔镜治疗是安全的，且发病率低。
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