The Clinical Application Of Transvaginal Of Three-dimendional Transvaginal Ultasonogarphy And Hysterosalpingography In Diagnosis Of Intrauterine Adhesions

Objective:To analyze the sensitivity,specificity and coincidence rate of transvaginal three-dimensional ultrasound(3D-TVS)and hysterosalpingography(HSG)in the diagnosis of intrauterine adhesions(IUA),as well as the sensitivity of IUA in different degrees and different parts To investigate the distribution of endometrial volume(EV)and the clinical value of these two methods in the diagnosis of IUA.Methods:A total of 77 patients with IUA from January 2016 to July 2019 were enrolled.HSG,transvaginal two-dimensional ultrasound(2D-TVS)and 3D-TVS were performed in the same menstrual cycle.The gold standard was hysteroscopy.Among them,68 patients were diagnosed as IUA by hysteroscopy.The sensitivity,specificity and diagnostic coincidence rate of different diagnostic methods were analyzed.The sensitivity of different diagnostic methods and different parts of IUA were analyzed according to the classification and classification.The patients who were diagnosed as IUA by 3D-TVS were measured by volume automatic measurement technology(vocal software)EV was measured,and the results were statistically analyzed.Results:1.The sensitivity,specificity and coincidence rate of HSG in the diagnosis of IUA were 92.6%,77.8%and 90.9%,respectively.The area under ROC curve was 0.852,which was the highest among the three methods,and the sensitivity was also the highest in the diagnosis of various degrees and adhesions;2.The sensitivity,specificity and coincidence rate of 3D-TVS in the diagnosis of IUA were 88.2%,66.7%and 85.7%,respectively,and the area under ROC curve was 0.775;the sensitivity of 3D-TVS in the diagnosis of middle and severe intrauterine adhesions,central and mixed adhesions was higher;the EV value measured by 3D-TVS was related to the degree of adhesions,the EV value of high adhesions was lower,and the EV value of low adhesions was higher,and the comparison between the two groups was made.The difference of EV between different adhesion degrees was statistically significant(P<0.001).3.There was no significant difference in the sensitivity and specificity of HSG and 3D-TVS in the diagnosis of IUA(P>0.05).There was no significant difference in the sensitivity of three different levels of IUA(P>0.05).There was no significant difference in the sensitivity of different parts of IUA(P>0.05).Conclusion:1.HSG and 3D-TVS have high clinical value in the diagnosis of IUA.The two methods have the same diagnostic value in different parts and different degrees of IUA;2.3D-TVS can evaluate the severity of IUA by measuring ev.Compared with HSG,3D-TVS can provide more reliable parameters for the diagnosis of IUA,which is better than HSG;3.Under the non-invasive condition,3D-TVS is more suitable as the primary screening and important reexamination means of IUA than HSG.