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目的探讨经阴道二维超声(2D-TVS)、经阴道三维超声(3D-TVS)联合检查在宫腔粘连(IUA)患者诊断中的价值。方法选取我院收治的疑似IUA患者84例,对患者分别行2D-TVS、3D-TVS检查及二者联合检查,并与宫腔镜检查结果进行对比,观察与宫腔镜检查结果的符合情况,并计算检查灵敏度、特异度及约登指数(Youden指数)。结果 2D-TVS诊断IUA的与宫腔诊断符合率为71.4%,特异度为62.5%,灵敏度为72.4%,Youden指数为0.35;3D-TVS诊断IUA的与宫腔诊断符合率为82.1%,特异度为87.6%,灵敏度为81.2%,Youden指数为0.69;两种方法单一查检诊断IUA的诊断符合率、特异度、灵敏度、Youden指数比较无统计学差异(P>0.05);2D-TVS、3D-TVS联合检查宫腔诊断符合率为95.2%,特异度为75.0%,灵敏度为94.7%,Youden指数为0.70,联合检查诊断IUA的符合率、特异度、灵敏度、Youden指数与单一检查结果比较差异均有统计学意义(P<0.05)。结论 2D-TVS、3D-TVS联合检查,可显著提高IUA诊断准确性,简便、高效,可作为IUA诊断的首选检查方法。
Objective To investigate the value of transvaginal two-dimensional ultrasound (2D-TVS) and transvaginal three-dimensional ultrasound (3D-TVS) in the diagnosis of intrauterine adhesions (IUA). Methods Eighty-four patients with suspected IUA admitted to our hospital were selected for 2D-TVS, 3D-TVS and combined examinations. The results were compared with those of hysteroscopy to observe the coincidence with hysteroscopy , And check the sensitivity, specificity and Youden index (Youden index). Results The coincidence rate of IUD in 2D-TVS and uterine cavity was 71.4%, the specificity was 62.5%, the sensitivity was 72.4%, and the Youden index was 0.35. The coincidence rate of 3D-TVS and IUA was 82.1% The sensitivity was 81.2%, the Youden index was 0.69; The coincidence rate, specificity, sensitivity and Youden index of two methods of single diagnosis in diagnosis of IUA showed no statistical difference (P> 0.05); 2D-TVS, 3D -TVS combined with uterine cavity diagnosis was 95.2%, specificity was 75.0%, the sensitivity was 94.7%, Youden index was 0.70, the coincidence rate, specificity, sensitivity, Youden index of the combined diagnosis of IUA were compared with the single test results All were statistically significant (P <0.05). Conclusions 2D-TVS and 3D-TVS combined examination can significantly improve the diagnostic accuracy of IUA, which is simple and effective and can be used as the first choice for IUA diagnosis.