Transvaginal Three-dimensional Ultrasound And The Study Of The Value Of Hysteroscopy In The Diagnosis Of Endometrial Lesions

Purposes: To explore the endometrial lesions by using vaginal the transvaginal three-dimensional ultrasound(3D-TVS)and clinical diagnostic value of hysteroscopy(HS).Methods: Selection in our hospital between December 2015 and October 2016 admitted 88 examples patients with intrauterine membrane lesions,all patients via 3D-TVS and HS examination,HS examination revealed suspicious lesions,biopsy or surgery,there is a clear pathological results.Compared to two kinds of inspection for the diagnostic accordance rate of various endometrial lesions,statistical analysis.Results: 88 patients were those who had not seen was abnormal 3D-TVS 10 cases,9 cases confirmed by pathology in which no exception;3D-TVS in the diagnosis of endometrial lesions in 78 cases,the pathological diagnosis of endometrial lesions in 79 cases.28 cases of endometrial thickening of the living,33 cases of pathological diagnosis of endometrial thickening of the living,and the pathological diagnosis coincidence rate 84.85%,15 cases of endometrial polyps,21 cases of pathological diagnosis,and the pathological diagnosis coincidence rate 71.43%,8 cases of submucosal fibroids,14 cases of pathological diagnosis,and pathological diagnosis coincidence rate 57.14%,7 cases of endometrial carcinoma,10 cases of pathological diagnosis,and pathological diagnosis coincidence rate 70%,chronic nonspecific endometritis in 1 case,pathologic diagnosis in 1 case,and the pathological diagnosis coincidence rate 100%,normal in 5 cases,9 cases of pathological diagnosis,and pathological diagnosis coincidence rate 55.56%.All patients,no HS was abnormal in 10,9 cases confirmed by pathology in which no exception;Diagnosis of endometrial lesions in 78 cases,the pathological diagnosis of endometrial lesions in 79 cases.Diagnosis of endometrial thickening of the living 30 cases,33 cases of pathological diagnosis of endometrial thickening of the living,and the pathological diagnosis coincidence rate 90.91%,18 cases of endometrial polyps,21 cases of pathological diagnosis,and the pathological diagnosis coincidence rate 85.71%,12 cases of submucosal fibroids,14 cases of pathological diagnosis,and the pathological diagnosis coincidence rate85.71%,9 cases of endometrial carcinoma,10 cases of pathological diagnosis,and the pathological diagnosis coincidence rate 90%,chronic nonspecific endometritis in 1 case,pathologic diagnosis in 1 case,and the pathological diagnosis coincidence rate 100%,normal7 cases,9 cases of pathological diagnosis,and pathological diagnosis coincidence rate77.78%.3D-TVS diagnostic sensitivity was 93.67%,specificity of 55.56%,positive predictive value was 94.87% and negative predictive value was 50%;HS examination sensitivity was96.20%,specificity of 60%,positive predictive value was 97.44% and negative predictive value of 30%.The above the results showed that the sensitivity,specificity,positive predictive value of HS were higher than 3D-TVS,but negative predictive value of HS examination under 3D-TVS examination,two groups of test negative predictive value(p < 0.05,the difference was statistically significant.Prompt HS examination has better sensitivity and the smaller the missed diagnosis;Vaginal ultrasound and three smaller misdiagnosis rate,there was no statistically significant difference in specific ways.Two methods of endometrial hyperplasia and pathological diagnosis coincidence rate,p > 0.05,no significant difference of statistics;For endometrial polyps and submucous myoma,endometrial cancer,chronic nonspecific endometritis,the diagnostic accordance rate of normal and pathological diagnosis coincidence rate,p < 0.05,compare the difference was statistically significant.Overall,the two sets of inspection diagnosis coincidence rate shows 3D-TVS and pathology was 72.73%,HS examination was 87.5%,the comparison shows that there is statistical significance(P <0.05).Conclusion: 3D-TVS technology has a simple and economical,effective and noninvasive advantages of endometrial lesions is the preferred examination method.And HS examination can directly observe uterine cavity and lining,but it is a check and more expensive,high technical requirements,some patients can’t tolerate check,can’t show the appearance of the uterus and pelvic,muscular cannot evaluate endometrial cancer invasion,so not as a preliminary examination.3 D-response were examined by TVS,as a kind of early screening,such as suspected endometrial lesions or for 3D-TVS inspection line without exception but symptoms HS inspection,so as to improve the positive rate of the endometrial lesions.3D-TVS provide diagnostic basis for HS,should be the first choice of the diagnosis of endometrial lesions and early screening examination method.