围绝经期和绝经后子宫异常出血患者诊断性宫腔镜检查与经阴道超声检查的对比研究

[Comparative study of diagnostic hysteroscopy and transvaginal ultrasonography in patients with abnormal uterine hemorrhage during the peri- and post-menopausal period].

作者信息

Barbero M, Enria R, Pagliano M, Canni M, Nicolaci P, Bertini U, Bocci F, Bocci C, Chiara G

机构信息

Dipartimento di Discipline Ginecologiche ed Ostetriche, Università degli Studi, Torino.

出版信息

Minerva Ginecol. 1997 Nov;49(11):491-7.

PMID:9489347

Abstract

BACKGROUND

The aim of this study was to determine the diagnostic value of hysteroscopy and transvaginal ultrasonography in patients with abnormal uterine bleeding (AUB) in the peri and postmenopausal period.

METHODS

302 patients with AUB, underwent hysteroscopy and in 86 cases, also a transvaginal ultrasonography before hysteroscopy was performed. Results were compared with the histological diagnosis.

RESULTS

The diagnostic accuracy of hysteroscopy was very high in the cases of endometrial carcinoma (sensibility 100%, specificity 99%), and lower in the cases of endometrial hyperplasia (sensibility 69%, specificity 72%) and endometrial atrophy (sensibility 29% and specificity 97%). Sonography proved to be less reliable in the diagnosis of endometrial pathology (carcinoma: sensibility 57%, specificity 100%, hyperplasia: sensibility 62.5% specificity 63%). The results of this study show that sonography may be used as a first choice diagnostic test in the investigation of women with AUB.

CONCLUSIONS

Hysteroscopy represent a second diagnostic step for achieving a proper histologic diagnosis.

摘要

背景

本研究的目的是确定宫腔镜检查和经阴道超声检查对围绝经期和绝经后异常子宫出血（AUB）患者的诊断价值。

方法

302例AUB患者接受了宫腔镜检查，其中86例在进行宫腔镜检查前还接受了经阴道超声检查。将结果与组织学诊断进行比较。

结果

宫腔镜检查对子宫内膜癌的诊断准确性非常高（敏感性100%，特异性99%），而对子宫内膜增生（敏感性69%，特异性72%）和子宫内膜萎缩（敏感性29%，特异性97%）的诊断准确性较低。超声检查在子宫内膜病变诊断中可靠性较低（癌：敏感性57%，特异性100%；增生：敏感性62.5%，特异性63%）。本研究结果表明，超声检查可作为AUB女性患者检查的首选诊断方法。