经阴道超声检查在子宫内膜息肉诊断中的应用价值 目的：探讨经阴道超声检查（TVS）在子宫内膜息肉（EMPs）诊断中的应用价值。 方法：回顾性分析 2016 年 1 月至 2019 年 12 月在我院就诊的经宫腔镜检查和病理证实的 90 例 EMPs 患者的临床资料，所有患者术前均行 TVS 检查，以宫腔镜检查及病理结果为金标准，计算 TVS 检查诊断 EMPs 的灵敏度、特异度、阳性预测值、阴性预测值及准确性，并分析 TVS 对息肉大小、数目、位置、内部回声及血流情况的诊断价值。 结果：宫腔镜检查及病理诊断为 90 例 EMPs，单发 62 例（68.9%），多发 28 例（31.1%）；息肉直径 0.5～2.5cm，平均（1.12±0.51）cm。TVS 检查诊断 EMPs 的灵敏度、特异度、阳性预测值、阴性预测值及准确性分别为 97.8%（88/90）、91.1%（82/90）、96.7%（88/91）、94.4%（82/87）、95.6%（170/178）。TVS 诊断 EMPs 的大小与病理结果呈正相关（r=0.834，P<0.001）。单发息肉与多发息肉在形态、内部回声及血流分布方面比较，差异均有统计学意义（P<0.05）。 结论：TVS 检查诊断 EMPs 具有较高的灵敏度、特异度、准确性，可作为 EMPs 的首选筛查方法。
Clinical evaluation of women with PMB. Is it always necessary an endometrial biopsy to be performed? A review of the literature.
机构信息
Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
出版信息
Arch Gynecol Obstet. 2011 Feb;283(2):261-6. doi: 10.1007/s00404-010-1601-3. Epub 2010 Aug 4.
Abstract
BACKGROUND
Endometrial carcinoma is the most distressing cause of abnormal vaginal bleeding. The intention of clinical management in the case of postmenopausal bleeding is to achieve an accurate diagnosis without overinvestigation.
METHOD
We studied the available literature on the diagnostic evaluation of postmenopausal women with vaginal bleeding, accentuating the most important aspects on this topic: the accuracy of sonography and endometrial biopsy in predicting endometrial hyperplasia and endometrial carcinoma.
RESULTS
The accuracy of the above tests in predicting endometrial hyperplasia and endometrial carcinoma is a subject of continuing debate. Μοreover, in the last decades, there has been an explosion of publications indicating that ultrasound may be useful in predicting endometrial pathology.
CONCLUSION
Since advanced endometrial carcinoma has been known to occur in cases without noticeable endometrial thickness on ultrasound, the clinician should beware of the diagnostic evaluation of postmenopausal women with vaginal bleeding.
摘要
背景
子宫内膜癌是导致绝经后阴道出血的最令人痛苦的原因。对于绝经后出血的临床管理，目的是在不进行过度检查的情况下做出准确诊断。
方法
我们研究了绝经后阴道出血妇女的诊断评估的现有文献，强调了该主题的最重要方面：超声和子宫内膜活检在预测子宫内膜增生和子宫内膜癌中的准确性。
结果
上述检查在预测子宫内膜增生和子宫内膜癌中的准确性是一个持续争论的话题。此外，在过去几十年中，有大量出版物表明，超声可能有助于预测子宫内膜病变。
结论
由于在超声检查中未见明显子宫内膜增厚的情况下也已发现晚期子宫内膜癌，因此临床医生应警惕对绝经后阴道出血妇女的诊断评估。
相似文献
1
Clinical evaluation of women with PMB. Is it always necessary an endometrial biopsy to be performed? A review of the literature.经阴道超声检查在子宫内膜息肉诊断中的应用价值
目的：探讨经阴道超声检查（TVS）在子宫内膜息肉（EMPs）诊断中的应用价值。
方法：回顾性分析 2016 年 1 月至 2019 年 12 月在我院就诊的经宫腔镜检查和病理证实的 90 例 EMPs 患者的临床资料，所有患者术前均行 TVS 检查，以宫腔镜检查及病理结果为金标准，计算 TVS 检查诊断 EMPs 的灵敏度、特异度、阳性预测值、阴性预测值及准确性，并分析 TVS 对息肉大小、数目、位置、内部回声及血流情况的诊断价值。
结果：宫腔镜检查及病理诊断为 90 例 EMPs，单发 62 例（68.9%），多发 28 例（31.1%）；息肉直径 0.5～2.5cm，平均（1.12±0.51）cm。TVS 检查诊断 EMPs 的灵敏度、特异度、阳性预测值、阴性预测值及准确性分别为 97.8%（88/90）、91.1%（82/90）、96.7%（88/91）、94.4%（82/87）、95.6%（170/178）。TVS 诊断 EMPs 的大小与病理结果呈正相关（r=0.834，P<0.001）。单发息肉与多发息肉在形态、内部回声及血流分布方面比较，差异均有统计学意义（P<0.05）。
结论：TVS 检查诊断 EMPs 具有较高的灵敏度、特异度、准确性，可作为 EMPs 的首选筛查方法。
Arch Gynecol Obstet. 2011 Feb;283(2):261-6. doi: 10.1007/s00404-010-1601-3. Epub 2010 Aug 4.
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ACOG Committee Opinion No. 426: The role of transvaginal ultrasonography in the evaluation of postmenopausal bleeding.美国妇产科医师学会委员会意见第426号：经阴道超声检查在绝经后出血评估中的作用。
Obstet Gynecol. 2009 Feb;113(2 Pt 1):462-4. doi: 10.1097/AOG.0b013e31819930cc.
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