TUI联合三维超声综合评分法诊断宫腔粘连及评估病情严重程度的作用

TUI联合三维超声综合评分法诊断宫腔粘连及评估病情严重程度的作用

摘要：目的：探讨断层超声显像（TUI）联合三维超声综合评分法诊断宫腔

粘连（IUA）及评估病情严重程度的作用。方法：纳入我院（2021年6月~2023

年1月）收治的90例疑似IUA患者，均进行TUI、三维超声综合评分法诊断，以

宫腔镜检查结果为金标准，分析TUI、三维超声综合评分法及两者联合诊断宫腔

粘连的价值，并探讨不同病情严重程度患者的TUI特征。结果：与TUI检查相比，联合诊断准确度、敏感度更高，P<0.05；两种检查特异度对比，P>0.05；与三维

超声综合评分法相比，联合诊断敏感度、敏感度、特异度均更高，P<0.05。经宫

腔镜确诊的75例患者中，轻度、中度、重度粘连者分别有29例、28例、18例。分别与轻度、中度宫腔粘连患者相比，重度宫腔粘连TUI边缘不光整率更高，

P<0.05；不同宫腔粘连患者TUI缺损、钙化、内聚率对比，P>0.05。结论：TUI

联合三维超声综合评分法对IUA的诊断准确度较高。

关键词：断层超声显像；三维超声综合评分法；宫腔粘连；宫腔镜；准确度

The role of TUI combined with three-dimensional ultrasound comprehensive score in diagnosis of uterine cavity adhesion and evaluation of the severity of the disease

[Abstract] Objective: To explore the role of tomographic

ultrasound imaging (TUI) combined with three-dimensional ultrasound comprehensive scoring in the diagnosis of intrauterine adhesion (IUA) and the evaluation of the severity of the disease. Methods: 90 suspected patients with IUA admitted to our hospital (June

2021~January 2023) were diagnosed by TUI and three-dimensional ultrasound comprehensive scoring method. Taking the results of hysteroscopy as the gold standard, the value of TUI, three-dimensional

ultrasound comprehensive scoring method and their combination in the diagnosis of uterine cavity adhesion was analyzed, and the TUI characteristics of patients with different disease severity were discussed. Results: Compared with TUI, the accuracy and sensitivity of combined diagnosis were higher, P<0.05; The specificity of the two

tests was compared, P>0.05; Compared with three-dimensional ultrasound comprehensive scoring method, the sensitivity, sensitivity and

specificity of combined diagnosis were higher (P<0.05). Of the 75 patients confirmed by hysteroscopy, there were 29, 28 and 18 cases of mild, moderate and severe adhesion respectively. Compared with

patients with mild and moderate intrauterine adhesions, the TUI margin irregularity rate of severe intrauterine adhesions was higher (P<0.05); Comparison of TUI defect, calcification and cohesion rate in patients with different intrauterine adhesions (P>0.05). Conclusion:TUI combined with three-dimensional ultrasound comprehensive scoring

method has high accuracy in the diagnosis of IUA.

[Key words] Tomographic ultrasound imaging; Three-dimensional ultrasound comprehensive scoring method; Uterine cavity adhesion; Hysteroscopy; Accuracy

宫腔粘连主要是由于妊娠或非妊娠子宫的创伤，子宫内膜基底层受损，宫腔

部分/全部闭塞，从而引起月经异常、不孕、反复流产等症状[1]。施佳艳[2]学者研

究中选取的213例宫腔镜检查病人，38例确诊为宫腔粘连，发病率高达17.84%，且近年来此病发病率呈逐年上升趋势，对女性生殖影响极大。宫腔镜检查为诊断

此病的金标准，但具有侵入性，患者接受度不高。三维超声可清晰显示人体内部

形态结构，操作安全、灵活、直观，其中三维超声评分法可综合性评估内膜形态、厚度、异常回声情况等，但需多次、重复获取不同层面的冠状切面图，影响诊断

效能[3]。断层超声显像（TUI）为一种新兴的三维超声显像模式，可获取连续断层图像，多角度、多层面评估宫腔形态及内膜信息。但目前，临床关于TUI+三维超