The diagnostic value of transvaginal two-dimensional ultrasound and three-dimensional ultrasound volume imaging technology for intrauterine adhesions / 中国医师杂志

ABSTRACT

Objective:To analyze the diagnostic value of transvaginal two-dimensional ultrasound and three-dimensional ultrasound volume imaging (3DVI) technology for intrauterine adhesions.Methods:A total of 120 suspected patients with intrauterine adhesions admitted to Beijing Tongzhou District Maternal and Child Health Hospital from July 2022 to June 2023 were selected as the research subjects. All patients underwent transvaginal two-dimensional ultrasound and 3DVI technology examination, and the diagnostic value of vaginal two-dimensional ultrasound and 3DVI technology single examination and combined examination was compared based on the results of hysteroscopy examination as the gold standard; Comparison of ultrasound parameters between the intrauterine adhesions group and the non intrauterine adhesions group, as well as patients with different degrees of intrauterine adhesions [endometrial thickness (ED), endometrial volume (EV), vascular index (VI), blood flow index (FI), vascular comprehensive index (VFI)].Results:Among 120 suspected patients with intrauterine adhesions, 104 cases were positive in hysteroscopy examination, with a positive rate of 86.67%. Among them, 50 cases were mild, 36 cases were moderate, and 18 cases were severe. 76 cases were positive in vaginal two-dimensional ultrasound examination, with a positive rate of 63.33%; 79 cases were positive for 3DVI technology examination, with a positive rate of 65.83%; The combined examination results of vaginal two-dimensional ultrasound and 3DVI technology were positive in 87 cases, with a positive rate of 72.50%. The sensitivity, specificity, positive predictive value, and negative predictive value of vaginal two-dimensional ultrasound examination were 68.27%, 68.75%, 93.42%, and 25.00%, respectively. The 3DVI technique examination was 73.08%, 81.25%, 96.20%, and 31.71%, respectively. The combined examination was 83.65%, 100.00%, 100.00%, and 48.48%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the combined examination were all higher than those of vaginal two-dimensional ultrasound examination (all P<0.05). 104 cases in the intrauterine adhesions group and 16 cases in the non intrauterine adhesions group; The ED, EV, VI, FI, and VFI of the intrauterine adhesions group were lower than those of the non intrauterine adhesions group (all P<0.05). The differences in ED, EV, and VI among patients with different degrees of intrauterine adhesions were statistically significant (all P<0.05); The ED, EV, and VI in the moderate group were lower than those in the mild group (all P<0.05), while the ED, EV, and VI in the severe group were lower than those in the mild and moderate groups (all P<0.05), and the FI was lower than those in the mild group ( P<0.05). Conclusions:Transvaginal two-dimensional ultrasound combined with 3DVI technology has high diagnostic value for intrauterine adhesions and can be used to evaluate the degree of intrauterine adhesions.