Efficacy of transvaginal three-dimensional ultrasound in diagnosing types and degrees of uterine cavity adhesions
10.3760/cma.j.cn341190-20240227-00198
- VernacularTitle:经阴道三维超声诊断宫腔粘连类型及粘连程度的效能分析
- Author:
Yan CHEN
1
;
Dongli SHAN
Author Information
1. 安康市妇幼保健院产科，安康 725000
- Publication Type:Journal Article
- Keywords:
Uterine diseases;
Tissue adhesions;
Hysteroscopy;
Ultrasonography, doppler, color;
Endosonography;
Pulsatile flow;
Diagnosis;
Sensitivity and specificity
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(4):498-502
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of transvaginal three-dimensional (3D)ultrasound in diagnosing different types of cervical adhesions and the relationship between relevant quantitative parameters and the degree of adhesion in patients.Methods:A cross-sectional study was conducted involving 112 patients with suspected intrauterine adhesions who were treated at Ankang Maternal and Child Health Hospital from August 2020 to September 2023. All patients underwent both two-dimensional (2D) and 3D ultrasound examinations. The diagnostic efficacy of the two imaging modalities for identifying intrauterine adhesions and different types of intrauterine adhesions was compared. Additionally, the relationship between transvaginal ultrasound parameters and the severity of intrauterine adhesions in patients was analyzed.Results:Among the 112 patients, 96 were diagnosed with intrauterine adhesions and 16 with non-adhesions through hysteroscopy. The sensitivity, specificity, and accuracy of transvaginal 3D ultrasound for diagnosing intrauterine adhesions were found to be 92.7%, 93.8%, and 92.9%, respectively. These values were significantly higher than those for transvaginal 2D ultrasound, which had sensitivity, specificity, and accuracy rates of 81.3%, 60.3%, and 78.6%, respectively ( χ2 = 5.57, 4.57, 9.33, all P < 0.05). When examining different types of intrauterine adhesions, the sensitivity (93.5%, 87.5%, and 84.6%), specificity (98.5%, 97.7%, and 96.5%), and accuracy (96.4%, 95.5%, and 93.8%) of 3D ultrasound for central, peripheral, and mixed types were all significantly higher than those of transvaginal 2D ultrasound (73.9%, 62.5%, and 53.9% for sensitivity; 89.4%, 89.8%, and 88.4% for specificity; and 83.0%, 83.9%, and 80.4% for accuracy) ( χ2 = 6.45, 4.00, 5.78, 4.79, 4.75, 4.08, 10.90, 8.19, 8.91, all P < 0.05). The vascularization blood flow index, vascularization index, and blood flow index for mild adhesions were (0.91 ± 0.11), (3.44 ± 0.41), and (23.94 ± 2.46), respectively. For moderate adhesions, these indices were (0.53 ± 0.06), (2.63 ± 0.31), and (20.14 ± 2.09), and for severe adhesions, they were (0.29 ± 0.04), (1.41 ± 0.17), and (18.01 ± 1.93). The differences among these groups were statistically significant ( F = 319.09, 180.36, 48.19, all P < 0.001). Conclusions:The diagnostic efficacy of transvaginal 3D ultrasound for intrauterine adhesions and the classification of these adhesions is superior to that of conventional transvaginal 2D ultrasound. Additionally, the relevant quantitative parameters are closely associated with the degree of intrauterine adhesions in patients.
