经阴道彩色多普勒超声对绝经后女性宫腔病变的诊断价值

焦焰燃; 王铮; 万青; 王元媛

doi:10.7619/jcmp.20253756

经阴道彩色多普勒超声对绝经后女性宫腔病变的诊断价值

Diagnostic value of transvaginal color Doppler ultrasound in detecting uterine cavity lesions in postmenopausal women

摘要

摘要:
目的探讨经阴道彩色多普勒超声对绝经后宫腔病变的诊断价值。
方法选取绝经后疑似宫腔病变患者210例为研究对象。患者入院后均接受经阴道彩色多普勒超声和经腹彩色多普勒超声检查。以诊断性刮宫术和宫颈活检的病理结果为金标准，最终确诊宫腔病变107例、宫颈病变103例。比较经阴道彩色多普勒超声和经腹彩色多普勒超声检查在绝经后宫腔病变患者诊断中的敏感度、特异度和准确度。
结果经阴道彩色多普勒超声检查的误诊率为6.19%(13/210), 低于经腹彩色多普勒超声检查的18.10%(38/210), 差异有统计学意义(P < 0.05); 经阴道彩色多普勒超声检查的阳性预测值、阴性预测值均高于经腹彩色多普勒超声检查，差异有统计学意义(P < 0.05)。经阴道彩色多普勒超声检查的诊断敏感度、特异度和准确度分别为91.59%(98/107)、96.12%(99/103)、93.81%(197/210); 经腹彩色多普勒超声检查的诊断敏感度、特异度和准确度分别为78.50%(84/107)、85.44%(88/103)、81.90%(172/210)。经阴道彩色多普勒超声检查对女性绝经后宫腔病变的诊断敏感度、特异度和准确度均高于经腹彩色多普勒超声检查，差异有统计学意义(P < 0.05)。对于不同宫腔病变类型患者，经阴道彩色多普勒超声检查的检出率高于经腹彩色多普勒超声检查，差异有统计学意义(P < 0.05)。
结论相较于经腹彩色多普勒超声检查，经阴道彩色多普勒超声检查在绝经后宫腔病变中的误诊率更低，且对不同类型宫腔病变的诊断准确度更高。

Abstract:
Objective To investigate the diagnostic value of transvaginal color Doppler ultrasound in detecting uterine cavity lesions in postmenopausal women.
Methods A total of 210 postmenopausal women with suspected uterine cavity lesions were selected as the study subjects. After admission, all patients underwent transvaginal color Doppler ultrasound and transabdominal color Doppler ultrasound examinations. The pathological results from diagnostic dilatation and curettage and cervical biopsy were used as the gold standard for final diagnosis, confirming 107 cases of uterine cavity lesions and 103 cases of cervical lesions. The sensitivity, specificity and accuracy of transvaginal color Doppler ultrasound and transabdominal color Doppler ultrasound in diagnosing uterine cavity lesions in postmenopausal women were compared.
Results The misdiagnosis rate of transvaginal color Doppler ultrasound was 6.19%(13/210), which was significantly lower than 18.10%(38/210) of transabdominal color Doppler ultrasound (P < 0.05). The positive predictive value and negative predictive value of transvaginal color Doppler ultrasound were both significantly higher than those of transabdominal color Doppler ultrasound (P < 0.05). The diagnostic sensitivity, specificity and accuracy of transvaginal color Doppler ultrasound were 91.59% (98/107), 96.12% (99/103) and 93.81% (197/210), respectively, while those of transabdominal color Doppler ultrasound were 78.50% (84/107), 85.44% (88/103) and 81.90% (172/210), respectively. The diagnostic sensitivity, specificity and accuracy of transvaginal color Doppler ultrasound for uterine cavity lesions in postmenopausal women were significantly higher than those of transabdominal color Doppler ultrasound (P < 0.05). For patients with different types of uterine cavity lesions, the detection rate of transvaginal color Doppler ultrasound was significantly higher than that of transabdominal color Doppler ultrasound (P < 0.05).
Conclusion Compared with transabdominal color Doppler ultrasound, transvaginal color Doppler ultrasound exhibits a lower misdiagnosis rate and higher diagnostic accuracy for different types of uterine cavity lesions in postmenopausal women.

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