摘要
目的:探讨经阴道三维超声(3D-TVS)联合磁共振成像(MRI)在先天性子宫畸形中的诊断价值。方法:选取2021年5月至2023年5月于我院就诊的85例疑似先天性子宫畸形患者为研究对象,经宫腔镜检查结果显示,阳性患者65例,阴性患者20例,统计3D-TVS、MRI单独及联合诊断结果,分析其诊断效能,分析3D-TVS、MRI单独及联合诊断的一致性。结果:相较于单独诊断,3D-TVS联合MRI诊断的灵敏度、准确度均较高,分别为95.38%、85.88%,漏诊率较低,为4.62%(P<0.05);3D-TVS结果显示8例完全纵隔子宫,11例非完全纵隔子宫,8例双子宫,8例单角子宫,5例双角子宫,5例残角子宫,4例弓形子宫,其一致性Kappa值为0.516;MRI结果显示6例完全纵隔子宫,10例非完全纵隔子宫,5例双子宫,10例单角子宫,8例双角子宫,7例残角子宫,3例弓形子宫,其一致性Kappa值为0.539;3D-TVS、MRI联合诊断显示,7例完全纵隔子宫,11例非完全纵隔子宫,5例双子宫,13例单角子宫,5例双角子宫,4例残角子宫,4例弓形子宫,其与宫腔镜结果的一致性Kappa值为0.756。结论:3D-TVS联合MRI诊断在先天性子宫畸形中具有较高的诊断灵敏度,漏诊率较低,可为临床鉴别不同类型子宫畸形提供可靠依据,具有较高的临床应用价值。
Objective:To investigate the diagnostic value of transvaginal three-dimensional ultrasound(3D-TVS)combined with magnetic resonance imaging(MRI)in congenital uterine malformations.Methods:A total of 85 patients with suspected congenital uterine malformation in our hospital from May 2021 to May 2023 were selected as the research objects.The hysteroscopy results showed that 65 cases were positive and 20 cases were negative.The diagnostic efficacy and consistency of 3D-TVS and MRI alone or in combination were analyzed.Results:Compared with the single diagnosis,the sensitivity and accuracy of 3D-TVS combined with MRI were higher(95.38%and 85.88%,respectively),and the missed diagnosis rate was lower(4.62%)(P<0.05).The results of 3D-TVS showed that there were 8 cases of complete mediastinal uterus,11 cases of incomplete mediastinal uterus,8 cases of double uterus,8 cases of unicornuate uterus,5 cases of bicornuate uterus,5 cases of rudimentary horn uterus,and 4 cases of arcuate uterus,the consistency Kappa value was 0.516.MRI results showed that there were 6 cases of complete mediastinal uterus,10 cases of incomplete mediastinal uterus,5 cases of double uterus,10 cases of unicornuate uterus,8 cases of bicornuate uterus,7 cases of rudimentary horn uterus,3 cases of arcuate uterus,and the consistency Kappa value was 0.539.The combined diagnosis of 3D-TVS and MRI showed that there were 7 cases of completely mediastinal uterus,11 cases of incompletely mediastinal uterus,5 cases of double uterus,13 cases of unicornuate uterus,5 cases of bicornuate uterus,4 cases of rudimentary horn uterus,and 4 cases of arcuate uterus,the Kappa value of consistency with hysteroscopy was 0.756.Conclusions:The combined application of 3D-TVS and MRI offers high diagnostic sensitivity and a low rate of missed diagnoses in the diagnosis of congenital uterine malformations.This approach provides a reliable basis for clinical differentiation of different types of uterine malformations and holds significant clinical application value.
作者
马肖会
高博
王莹
MA Xiaohui;GAO Bo;WANG Ying(Department of Ultrasound,Luoyang Mudan Obstetrics and Gynecology Hospital,Luoyang 471000,China;Department of Ultrasound,Henan Armed Police Corps)
出处
《沈阳医学院学报》
2024年第5期480-484,共5页
Journal of Shenyang Medical College
基金
河南省医学科技攻关计划联合共建项目(No.LHGJ20211150)。
