To Investigate The Value Of B-ultrasound,MRI And Hysteroscopy In Diagnosis Of Space-occupying Lesions In Uterine Cavity

Objective: To investigate the value of combined ultrasound,MRI and hysteroscopy in the diagnosis of uterine cavity lesions.Methods: Clinical data of 136 patients with suspected uterine cavity space occupying lesions admitted to our hospital from September 2015 to October 2017 were selected and retrospectively analyzed.136 patients underwent vaginal ultrasound(TVS),MRI examination before hysteroscopy,and hysteroscopic biopsy,specimens were sent for pathological examination.The sensitivity,specificity,positive predictive value,negative predictive value,likelihood ratio,Youden index,etc.for the diagnosis of various types of uterine cavity lesions by B-ultrasound,MRI,hysteroscopy and their different joint diagnosis methods were respectively performed.Comparative analysis.Results: Of the 136 patients with suspected uterine cavity space-occupying lesions,114 had abnormal uterine cavity and 22 had no intrauterine pathological changes.The abnormal uterine cavity included 56 cases of endometrial polyps,20 cases of submucous myoma,33 cases of endometrial hyperplasia,and 5 cases of endometrial carcinoma.Among them,benign lesions accounted for 96%(109/114)of the average age(41 ± 7 years old),5 patients with endometrial cancer,the average age of 51 years,are postmenopausal women.The sensitivity of B ultrasound to uterine cavity occupying lesions was low,but the specificity was high.The sensitivity,specificity,positive predictive value,positive likelihood ratio and Youden index of MRI in the diagnosis of submucous myoma and endometrial cancer were significantly higher than those in endometrial polyps and endometrial hyperplasia.The sensitivity,specificity,positive predictive value,negative predictive value,and aboutden index of hysteroscopy in benign uterine cavity lesions(such as endometrial polyps,submucous uterine fibroids,and endometrial hyperplasia)were significantly higher than those of B-ultrasound.And MRI.In 5 patients with endometrial cancer,the sensitivity of hysteroscopy was very low,only 20%.Combining microscopy with biopsy,diagnostic curettage,or electrocutometry,the diagnostic value was higher.The combined diagnostic ability of the three methods is higher than that of a single examination.The sensitivity,specificity,positive predictive value,positive likelihood ratio,and Youden index of B-hypergrain combined hysteroscopy for benign uterine cavity lesions are high.B-ultrasound combined MRI,B-ultrasound combined MRI and hysteroscopy for the diagnosis of endometrial cancer sensitivity,positive predictive value,the highest index.Conclusion: The uterine cavity space occupying lesions in women of childbearing age or perimenopausal period are mostly benign lesions.The combination of B-ultrasound and hysteroscopy is a good choice for diagnosis.For the postmenopausal women with high suspicion of uterine cavity disease or young patients with high-risk factors of endometrial cancer,B-ultrasound combined MRI should be routinely performed to firstly understand the nature of the lesions,and if necessary,combined with hysteroscopic biopsy to confirm the diagnosis.Hysteroscopic surgery should reduce the uterine pressure and shorten the uterine cavity operation time.