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| Influencing factors of the intrauterine adhesions after intrauterine operation and the diagnostic efficacy of the ultrasonic manifestations |
| Zhoushan Branch, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Zhoushan, Zhejiang Province, 316012 |
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Abstract To explore the image appearance and the influencing factors of intrauterine adhesions after intrauterine operation, and to analyze the diagnostic value of ultrasound for intrauterine adhesions. Methods: 40 patients with intrauterine adhesions after intrauterine operation in the observation group and 40 patients without intrauterine adhesions after intrauterine operation in the control group from October 2018 to October 2022 were analyzed retrospectively. All these patients had accepted the two-dimensional ultrasound and the hysteroscopic examinations. The ultrasound imaging performance of the patients in two groups and the diagnostic value of ultrasound for their intrauterine adhesions were analyzed. Multivariate logistic analysis was analyzed the influencing factors of intrauterine adhesions of the patients. Results: There were significantly differences in the distinct of boundary, the size of lesions, the uniform internal echo, and the thickness in uterine cavity echo of the patients between the two groups (P＜0.05). Based on the hysteroscopic results as the gold standard, 32 of 40 patients in the observation group were diagnosed with uterine adhesions by ultrasound, with the accuracy rate of 80.0%, and 8 cases were missed diagnosis, with the missed diagnosis rate of 20.0%. The patients in the observation group had accepted diagnosis by both hysteroscopy and ultrasound, and there was no significant difference in the results of intrauterine adhesion classification of the patients between the two methods (P>0.05). Base on the hysteroscopic diagnosis as the gold standard, the accuracy of the two-dimensional ultrasound diagnosis for the mild, the moderate, and the severe adhesions of the patients were 66.7%, 92.3%, and 88.9%, respectively. Multivariate analysis showed that the history of intrauterine operation, the history of curettage, the history of induced abortion, the induced abortion ≥2 times, the polyp > 6 pieces of the patients were the influential factors for the reoccurrence of their intrauterine adhesions after intrauterine operation. Conclusion: Two-dimensional ultrasound for diagnosing intrauterine adhesions of the patients after intrauterine operation has high accuracy and graded diagnostic efficacy of intrauterine adhesion, so the patients with risk factors of intrauterine adhesions should be paid attention to in clinic.
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