Coleman B G, Arger P H, Grumbach K, Menard M K, Mintz M C, Allen K S, Arenson R L, Lamon K A
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Radiology. 1988 Sep;168(3):639-43. doi: 10.1148/radiology.168.3.3043545.
Transvaginal (TV) and transabdominal (TA) sonography were compared in a prospective study. A total of 230 examinations (126 pelvic, 104 pregnancy) were performed on 215 patients, ranging in age from 14 to 80 years. The improved anatomic detail on TV scans yielded new information in 138 (60%) examinations and better visualization of pelvic structures in 51 (22%) examinations. There was no important difference in diagnostic information provided by the two imaging modalities in 36 (16%) cases, and TV images were worse in five (2%). The clinical diagnosis was altered on the basis of TV sonographic findings in 54 (24%) cases and confirmed with certainty in 166 (72%). Diagnostic problems posed by TA scanning were not resolved by TV scanning in ten (4%) instances. Statistical analysis indicated that TV scanning was significantly better than TA scanning in the visualization of gestational sac contents (P less than .005), detection of fetal heart motion (P less than .001), and evaluation of the endometrial canal in the retroverted or retroflexed uterus (P less than .001). TV scanning was significantly better than TA scanning in visualization of the ovaries in patients with uterine leiomyomas (P less than .005) but not significantly better in peri- and postmenopausal patients (P greater than .05).
在一项前瞻性研究中对经阴道（TV）超声和经腹（TA）超声进行了比较。对215例年龄在14至80岁之间的患者共进行了230次检查（126次盆腔检查，104次妊娠检查）。经阴道扫描改善的解剖细节在138次（60%）检查中产生了新信息，在51次（22%）检查中使盆腔结构的可视化更好。在36例（16%）病例中，两种成像方式提供的诊断信息没有重要差异，而经阴道图像在5例（2%）中较差。根据经阴道超声检查结果，54例（24%）病例的临床诊断发生了改变，166例（72%）病例得到了明确证实。在10例（4%）情况下，经腹扫描提出的诊断问题未通过经阴道扫描解决。统计分析表明，经阴道扫描在妊娠囊内容物的可视化（P＜0.005）、胎儿心动检测（P＜0.001）以及后倾或后屈子宫的子宫内膜管评估（P＜0.001）方面明显优于经腹扫描。在子宫平滑肌瘤患者中，经阴道扫描在卵巢可视化方面明显优于经腹扫描（P＜0.005），但在围绝经期和绝经后患者中没有明显更好（P＞0.05）。
