罗守娟 李超 谭丹丹

[摘要] 目的 觀察三维超声和二维超声对宫腔粘连的诊断价值。 方法 选择2017年1月～2019年1月来我院进行检查的疑似宫腔粘连的120例患者进行观察，其中经宫腔镜确诊100例，将100例宫腔粘连患者分别进行二维和三维超声检查，观察和分析其二维声像图表现及三维声像图表现，并对二维超声和三维超声的诊断准确率进行对比分析。 结果 宫腔粘连患者的二维和三维超声检查的声像图表现不同，二维超声对宫腔粘连的诊断准确率为69%，三维超声对宫腔粘连的诊断准确率为91%，三维超声对宫腔粘连诊断的准确率明显高于二维超声检查（P<0.05）。 结论 经阴道三维彩色多普勒超声检查在宫腔粘连的诊断上更加方便、快捷、无创，具有较高的诊断灵敏度，经阴道三维超声用于宫腔粘连检查可以弥补经阴道二维超声检查的薄弱环节，诊断准确率高，有利于及时发现和治疗宫腔粘连，值得广泛推广和应用。

[关键词] 宫腔粘连;三维超声;二维超声;诊断准确率

[中图分类号] R445.1;R711.74          [文献标识码] B          [文章编号] 1673-9701（2020）18-0121-03

Observation on the value of three-dimensional ultrasound and two-dimensional ultrasound in the diagnosis of intrauterine adhesions

LUO Shoujuan1   LI Chao2   TAN Dandan3

1.Color Ultrasound Room， Hospital of Digestive Diseases， Heilongjiang Provincial Hospital， Harbin   150001， China; 2.Imaging Diagnosis Centre， Heilongjiang Provincial Hospital， Harbin   150001， China; 3.Department of Physical Diagnosis， Heilongjiang Provincial Hospital， Harbin   150001， China

[Abstract] Objective To observe the diagnostic value of three-dimensional ultrasound and two-dimensional ultrasound in intrauterine adhesions. Methods 120 patients with suspected intrauterine adhesions who came to our hospital for examination from January 2017 to January 2019 were selected for observation. 100 patients were diagnosed by hysteroscopy， and 100 patients with intrauterine adhesions were examined by two-dimensional and three-dimensional ultrasound. The performances of two-dimensional audiovisual image and three-dimensional ultrasonogram were observed and analyzed， and the diagnostic accuracy of two-dimensional ultrasound and three-dimensional ultrasound was compared and analyzed. Results The ultrasonograms of two-dimensional and three-dimensional ultrasound of patients with intrauterine adhesions were different in performances. The accuracy of two-dimensional ultrasound in the diagnosis of intrauterine adhesions was 69%， and the accuracy of three-dimensional ultrasound in the diagnosis of intrauterine adhesions was 91%. The accuracy of three-dimensional ultrasound in the diagnosis of intrauterine adhesions was significantly higher than that of two-dimensional ultrasound， and the difference was statistically significant（P<0.05）. Conclusion Transvaginal three-dimensional color Doppler ultrasound is more convenient， rapid， and non-invasive in the diagnosis of intrauterine adhesions， and has a higher diagnostic sensitivity. Transvaginal three-dimensional ultrasound used for the examination of intrauterine adhesion can make up for the weak links of transvaginal two-dimensional ultrasound examination， and the diagnostic accuracy is higher， which is conducive to the timely detection and treatment of intrauterine adhesions， and is worthy of widespread promotion and application.

[Key words] Intrauterine adhesions; Three-dimensional ultrasound; Two-dimensional ultrasound; Diagnostic accuracy

宫腔粘连是育龄女性的常见妇科疾病之一，近年来随着人工流产的不断增加，其发病率逐年增加。宫腔粘连诊断的常用方法有子宫输卵管造影和宫腔镜检查，此两种检查患者多存在痛苦或不适感，并发症多[1-3]。且宫腔镜检查要求具备一定的设备条件和熟练的操作技术，费用偏高，并有可能发生子宫穿孔等并发症，限制了其在临床的普及及应用[4-7]。近年来随着超声技术的不断发展和广泛应用，超声以其简便、无创、费用低、痛苦小等优势被广泛应用于宫腔粘连的筛查和诊断中，并取得了较好的效果。目前临床主要有经阴道三维超声和二维超声，本研究主要对比分析三维超声和二维超声对宫腔粘连的诊断价值，现报道如下。……