Analyse Diagnostic Value In Diseases Relate To Uterine Cavity Between By Three-dimensional Transvaginal Ultrasound

Objective:1.Discussion diagnostic value and advantages of three-dimensional transvaginal ultrasonography(3D-TVS) in diseases relate to uterine cavity; 2. Discussion diagnostic value of 3D-TVS combined hysteroscopic in diseases relate to intrauterine device(IUD) displacement and locateingMethods: 1.Retrospective analysis was employed to analyze 116 patients with uterine cavity doubted by two-dimensional transvaginal ultrasonography(2D-TVS) admitted to Gynecology Department of General Hospital of Ningxia Medical University covering the period of October2014 to January 2016. Collected their test results of 2D-VS, 3D-TVS and hysteroscopy of(suspected endometrial lesions are required to have a pathological diagnosis).Hysteroscopy would be used as the diagnosis gold standard.Comparing to the 2D-TVS to analyse the diagnostic value and advantages of 3D-TVS in diseases relate to uterine cavity.2. Retrospective analysis was employed to analyze 40 patients with uterine septum doubted by 2D-TVS admitted to Gynecology Department of General Hospital of Ningxia Medical University covering the period of October 2014 to January 2016. Collecting their test results of 2D-TVS, 3D-TVS,comparatively analyse the diagnostic accuracy of only 3D-TVS in diseases relate to uterine septum.3. Retrospective analysis was employed to analyze 42 patients with IUD displacement doubted by 2D-TVS admitted to Gynecology Department of General Hospital of Ningxia Medical University covering the period of October 2014 to January 2016. Taken the result of hysteroscopy or laparoscopy as the standard and analyse the diagnostic accuracy of hysteroscopy combined with 3D-TVS in diseases relate to IUD displacement and locateing.Results: 1. The diagnosis coincidence of 3D-TVS in 116 patients: 62 cases of endometrial polyps,29 cases of submucosal uterine fibroids,8 cases of endometrial cancer, 17 casesofendometrial hyperplasia confirmed by hysteroscopy and pathological diagnosis.The diagnosis coincidence of 3D-TVS for endometrial polyps was 92.0%(57/62), for sbmucous uterine fibroids was 86.2%(25/29), for edometrial cancer was 75.0%(6/8), for edometrial hyperplasia was 70.5%(12/17), for the overalls was 86.2%(100/116).Carrying on a kappa test between hysteroscopy and 3D-TVS obtain a kappa value of 0.776, P <0.05, explaining the two methods are in a good agreement,.the kappa value of 3D-TVS for the diagnosis of endometrial polyps and submucosal fibroids were 0.774,0.837, P <0.05, higher consistency; for endometrial hyperplasia diagnosis were 0.655, slightly lower consistency.2.The diagnosis coincidence of 3D-TVS in 40 patients with uterine septum: 39 cases of uterine septum diagnosed by 3D-TVS, compared with diagnostic results of B ultrasound combined hysteroscopy 3D-TVS diagnosis consistency rate is 97.5%(39/40), haveing an advantage on 2D-TVS. ?2 = 6.74, P <0.05, the difference between them was statistically significant.3. The diagnosis coincidence of hysteroscopy combined with 3D-TVS in 42 patients with IUD displacement: 29 cases of part ectopic IUD,11 cases of completely ectopic IUD;2 cases of IUD locating outside the uterus were finally diagnosed by hysteroscopy or laparoscopy. The diagnosis coincidence of hysteroscopy combined with 3D-TVS for part ectopic IUD was 90.0%(26/29),for completely ectopic IUD was 90.1%(10/11), for IUD locating outside the uterus was 50%(1/2), for the overall diagnostic accuracy of 88.1%(37/42). taking the kappa test between the two test results obtain a kappa value of 0.75, Kappa ?0.75, P <0.05,explaining the two methods are in a good agreement and statistically significant.Compared with the gold standard the diagnosis accuracy of 3D-TVS combined with hysteroscopy is in a higher coincidence in ectopic IUD and localization.Conclusions:1. Compared to 2D-TVS, 3D-TVS have a significant diagnosis advantage in diseases relate to uterine cavity, especially helpful for diagnosis of endometrial polyp and submucosal fibroids.2.3D-TVS have a higer accuracy in the diagnosis of uterine septum than 2D-TVS,it can be used as the preferred screening method when doubting uterine septum3. 3D-TVS combined with hysteroscopy have a high diagnostic accuracy for IUD ectopic and are Worthy of clinical promotion.