The Diagnostic Value of Ultrasound in Intrauterine Adhesions

CHEN Can-ming; WANG Yi-fang; YOU Pei; HUANG Tao; REN Wei-juan; GU Xiao-yan

Abstract：Objective:To evaluate the application of ultrasound in diagnosis of intrauterine adhesions, so as to find a simple and practicable method for the intrauterine adhesion screening. Methods:Ultrasound and hysteroscopy were performed in 68 cases of the intrauterine adhesions suspected clinically. The diagnosis results were compared with the SPSS software, to evaluate their diagnostic values. The imaging features of intrauterine adhesions, together with hysteroscopic observation, were analyzed. Results:The imaging characteristics of two-dimensional ultrasound and three-dimensional ultrasound in diagnosing intrauterine adhesions were included:sensitivity (65%, 90%), specificity (100%, 100%), the positive predictive value (100%, 100%), the negative predictive value (28%, 57%), Jorden index (0.65, 0.90), Kappa (0.30, 0.68). Compared with the hysteroscopy, both two-dimensional ultrasound Kappa=0.50(Z=4.41,P<0.01) and three-dimensional ultrasound Kappa=0.35(Z=3.60, P<0.01) were feasible in diagnosis of different degrees of intrauterine adhesions. Conclusions:Ultrasonography can be used in diagnosis of intrauterine adhesions. Compared with two-dimensional ultrasound, three-dimensional ultrasound has higher diagnostic value. However, ultrasonography still has the missed diagnosis rate and the misdiagnosis rate on some degrees. Hysteroscopy can clarify a diagnosis. Ultrasound, as a noninvasive and relatively simple method, should be recommended as the intrauterine adhesions screening before hysteroscopy. Ultrasonography may provide an effective reference for hysteroscopic surgery.