超声检查联合宫腔镜检查在宫腔内占位性病变中的诊断价值。
Diagnostic Value of Ultrasonography Combined with Hysteroscopy in Intrauterine Space-Occupying Abnormalities.
机构信息
Department of Gynaecology, Jingmen First People's Hospital, Jingmen 448000, Hubei, China.
Department of Ultrasound, The First People's Hospital of Jingmen, Jingmen 448000, Hubei, China.
出版信息
Contrast Media Mol Imaging. 2022 Aug 30;2022:6192311. doi: 10.1155/2022/6192311. eCollection 2022.
The aim of this study was to analyze the diagnostic significance of ultrasonography combined with hysteroscopy for intrauterine space-occupying abnormalities. A total of 99 patients with uterine space-occupying abnormalities treated in hospitals were enrolled. The patients were divided into three groups according to different disease types: the submucosal myoma group, endometrial polyp group, and placenta residue group, with 33 patients in each group. The differences and diagnostic effects in intrauterine ultrasound, hysteroscopic findings, and surgical histopathology were observed in each group. Outcome measures: it was to compare the sensitivity, specificity, and accuracy of intrauterine ultrasound and angiography for intrauterine space-occupying lesions using surgical and pathological examination methods as the gold standard; the relationship between the location, number, size, appearance, and serosal layer of intrauterine lesions was clearly shown; the location, number, appearance, and echogenicity of space-occupying abnormalities under hysteroscopy were observed. The results showed that the diagnostic rates of endometrial polyps, submucous myoma, and residual placenta were 90.9%, 80.8%, and 72.7%, respectively. However, the sensitivity, specificity, and accuracy of ultrasonography in the diagnosis of endometrial polyps were 90.0%, 66.7%, and 87.9%, respectively; those of hysteroscopy in the diagnosis of endometrial polyps were 96.7%, 66.7%, and 93.9%, respectively; and combined diagnosis was 96.7%, 100.0%, 97.0%, 100.0%, and 75.0%. The sensitivity, specificity, and accuracy of ultrasonography in the diagnosis of submucous myoma of the uterus were 88.9%, 50.0%, and 81.8%, respectively; those of hysteroscopy in the diagnosis of submucous myoma of the uterus were 96.3%, 83.3%, and 93.9%, respectively; and combined diagnosis was 100.0%, 83.3%, 97.0%, 96.4%, and 100.0%. The sensitivity, specificity, and accuracy of ultrasonography in the diagnosis of uteroplacental remnants were 87.5%, 66.7%, and 81.8%, respectively; those of hysteroscopy in the diagnosis of uteroplacental remnants were 91.7%, 77.8%, and 87.9%, respectively; and combined diagnosis was 95.8%, 88.9%, 93.9%, 95.8%, and 88.9%. In summary, ultrasonography combined with hysteroscopy can improve the diagnostic sensitivity and accuracy for intrauterine space-occupying abnormalities.
本研究旨在分析超声联合宫腔镜检查对宫腔占位性病变的诊断意义。选取我院收治的宫腔占位性病变患者 99 例，根据不同疾病类型分为黏膜下肌瘤组、子宫内膜息肉组和胎盘残留组，每组 33 例。观察各组宫腔内超声、宫腔镜检查及手术病理结果的差异及诊断效果。观察指标：以手术病理检查为金标准，比较宫腔内占位性病变超声和血管造影的灵敏度、特异度和准确率；清晰显示宫腔内病变的位置、数量、大小、形态和浆膜层关系；观察宫腔镜下宫腔占位性病变的位置、数量、形态和回声。结果显示，子宫内膜息肉、黏膜下肌瘤和胎盘残留的诊断率分别为 90.9%、80.8%和 72.7%。然而，超声诊断子宫内膜息肉的灵敏度、特异度和准确率分别为 90.0%、66.7%和 87.9%；宫腔镜诊断子宫内膜息肉的灵敏度、特异度和准确率分别为 96.7%、66.7%和 93.9%；联合诊断的灵敏度、特异度和准确率分别为 96.7%、100.0%、97.0%、100.0%和 75.0%。超声诊断黏膜下子宫肌瘤的灵敏度、特异度和准确率分别为 88.9%、50.0%和 81.8%；宫腔镜诊断黏膜下子宫肌瘤的灵敏度、特异度和准确率分别为 96.3%、83.3%和 93.9%；联合诊断的灵敏度、特异度和准确率分别为 100.0%、83.3%、97.0%、96.4%和 100.0%。超声诊断胎盘残留的灵敏度、特异度和准确率分别为 87.5%、66.7%和 81.8%；宫腔镜诊断胎盘残留的灵敏度、特异度和准确率分别为 91.7%、77.8%和 87.9%；联合诊断的灵敏度、特异度和准确率分别为 95.8%、88.9%、93.9%、95.8%和 88.9%。综上所述，超声联合宫腔镜检查可提高宫腔占位性病变的诊断灵敏度和准确率。
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