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Abstract：
OBJECTIVE: To assess diagnostic accuracy of 3D transvaginal ultrasound (3D-TVS) compared with hysteroscopy in detecting uterine cavity abnormalities in infertile women.
METHODS: This prospective observational cross-sectional study was conducted during the July 2013 to December 2013 study period. Sixty-nine women with infertility were enrolled. In the mid to late follicular phase of each subject\'s menstrual cycle, 3D transvaginal ultrasound and hysteroscopy were performed on the same day in each patient. Hysteroscopy is widely considered to be the gold standard method for investigation of the uterine cavity. Uterine cavity characteristics and abnormalities were recorded. Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios were evaluated.
RESULTS: Hysteroscopy was successfully performed in all subjects. Hysteroscopy diagnosed pathological findings in 22 of 69 cases (31.8%). There were 18 endometrial polyps, 3 submucous myomas, and 1 septate uterus. Three-dimensional transvaginal ultrasound in comparison with hysteroscopy had 84.1% diagnostic accuracy, 68.2% sensitivity, 91.5% specificity, 79% positive predictive value, and 86% negative predictive value. The positive and negative likelihood ratios were 8.01 and 0.3, respectively. 3D-TVS successfully detected every case of submucous myoma and uterine anomaly. For detection of endometrial polyps, 3D-TVS had 61.1% sensitivity, 91.5% specificity, and 83.1% diagnostic accuracy.
CONCLUSIONS: 3D-TVS demonstrated 84.1% diagnostic accuracy for detecting uterine cavity abnormalities in infertile women. A significant percentage of infertile patients had evidence of uterine cavity pathology. Hysteroscopy is, therefore, recommended for accurate detection and diagnosis of uterine cavity lesion.
METHODS: This prospective observational cross-sectional study was conducted during the July 2013 to December 2013 study period. Sixty-nine women with infertility were enrolled. In the mid to late follicular phase of each subject\'s menstrual cycle, 3D transvaginal ultrasound and hysteroscopy were performed on the same day in each patient. Hysteroscopy is widely considered to be the gold standard method for investigation of the uterine cavity. Uterine cavity characteristics and abnormalities were recorded. Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios were evaluated.
RESULTS: Hysteroscopy was successfully performed in all subjects. Hysteroscopy diagnosed pathological findings in 22 of 69 cases (31.8%). There were 18 endometrial polyps, 3 submucous myomas, and 1 septate uterus. Three-dimensional transvaginal ultrasound in comparison with hysteroscopy had 84.1% diagnostic accuracy, 68.2% sensitivity, 91.5% specificity, 79% positive predictive value, and 86% negative predictive value. The positive and negative likelihood ratios were 8.01 and 0.3, respectively. 3D-TVS successfully detected every case of submucous myoma and uterine anomaly. For detection of endometrial polyps, 3D-TVS had 61.1% sensitivity, 91.5% specificity, and 83.1% diagnostic accuracy.
CONCLUSIONS: 3D-TVS demonstrated 84.1% diagnostic accuracy for detecting uterine cavity abnormalities in infertile women. A significant percentage of infertile patients had evidence of uterine cavity pathology. Hysteroscopy is, therefore, recommended for accurate detection and diagnosis of uterine cavity lesion.
摘要：
目的：评估3D经阴道超声（3D-TVS）与宫腔镜检查对不孕症妇女宫腔异常的诊断准确性。
方法：本前瞻性观察性横断面研究在2013年7月至2013年12月的研究期间进行。纳入了69名不孕妇女。在每个受试者月经周期的中晚期卵泡期，每位患者均在同一天进行3D经阴道超声和宫腔镜检查。宫腔镜检查被广泛认为是调查子宫腔的金标准方法。记录宫腔特征及异常。诊断准确性,灵敏度,特异性，正预测值，负预测值，并评估了正负似然比。
结果：所有受试者均成功进行了宫腔镜检查。69例中有22例(31.8%)经宫腔镜诊断为病理结果。有18个子宫内膜息肉,3个粘膜下肌瘤，和1个纵隔子宫。经阴道三维超声与宫腔镜相比诊断准确率为84.1%,灵敏度68.2%,91.5%特异性，79%的阳性预测值，和86%的阴性预测值。阳性和阴性似然比分别为8.01和0.3。3D-TVS成功检测到每一例粘膜下肌瘤和子宫异常。用于检测子宫内膜息肉，3D-TVS的灵敏度为61.1%，91.5%特异性，诊断准确率为83.1%。
结论：3D-TVS对不孕妇女宫腔异常的诊断准确率为84.1%。有相当比例的不育患者有子宫腔病理学证据。宫腔镜检查是，因此,建议准确检测和诊断子宫腔病变。
方法：本前瞻性观察性横断面研究在2013年7月至2013年12月的研究期间进行。纳入了69名不孕妇女。在每个受试者月经周期的中晚期卵泡期，每位患者均在同一天进行3D经阴道超声和宫腔镜检查。宫腔镜检查被广泛认为是调查子宫腔的金标准方法。记录宫腔特征及异常。诊断准确性,灵敏度,特异性，正预测值，负预测值，并评估了正负似然比。
结果：所有受试者均成功进行了宫腔镜检查。69例中有22例(31.8%)经宫腔镜诊断为病理结果。有18个子宫内膜息肉,3个粘膜下肌瘤，和1个纵隔子宫。经阴道三维超声与宫腔镜相比诊断准确率为84.1%,灵敏度68.2%,91.5%特异性，79%的阳性预测值，和86%的阴性预测值。阳性和阴性似然比分别为8.01和0.3。3D-TVS成功检测到每一例粘膜下肌瘤和子宫异常。用于检测子宫内膜息肉，3D-TVS的灵敏度为61.1%，91.5%特异性，诊断准确率为83.1%。
结论：3D-TVS对不孕妇女宫腔异常的诊断准确率为84.1%。有相当比例的不育患者有子宫腔病理学证据。宫腔镜检查是，因此,建议准确检测和诊断子宫腔病变。
