分子影像学杂志2026，Vol.49Issue(8)：1030-1036,7.DOI:10.12122/j.issn.1674-4500.2026.08.07
宫腔粘连严重程度的诊断:基于阴道三维超声参数联合血清肿瘤坏死因子-α、白细胞介素-17A
Diagnosis of the severity of intrauterine adhesions:based on three-dimensional transvaginal ultrasound parameters combined with serum tumor necrosis factor-α and interleukin-17A
摘要
Abstract
Objective To investigate the diagnostic value of transvaginal three-dimensional ultrasound parameters combined with serum tumor necrosis factor-α(TNF-α)and interleukin-17A(IL-17A)on the severity of intrauterine adhesions(IUA).Methods A total of 123 patients with suspected IUA who were treated in the hospital were selected from March 2024 to March 2026.All patients underwent transvaginal three-dimensional ultrasound examination and serum TNF-α and IL-17A detection.With hysteroscopy and American Fertility Society(AFS)score as the gold standard,the patients were divided into mild adhesion group(n=48),moderate adhesion group(n=41)and severe adhesion group(n=34).The differences in trnasvaginal three-dimensional ultrasound parameters[endometrial thickness(ED),endometrial volume(EV),vascularization flow index(VFI)]and serum TNF-α and IL-17 A levels were compared among the three groups.Pearson correlation was used to analyze the correlation between transvaginal three-dimensional ultrasound parameters,serum TNF-α and IL-17A and AFS score.Multivariate logistic regression model was utilized to analyze the influencing factors for severe IUA.ROC curve was drawn to analyze the efficiency of transvaginal three-dimensional ultrasound parameters,serum TNF-α and IL-17A alone and in combination in the diagnosis of severe IUA.Results The ED,EV and VFI were ranked from highest to lowest as follows:mild adhesion group,moderate adhesion group and severe adhesion group(P<0.05);Serum TNF-α and IL-17A levels in the three groups showed the opposite ranking(P<0.05).Pearson correlation analysis showed that ED,EV and VFI were all negatively correlated with AFS score(r=-0.589,-0.645,-0.621)while serum TNF-α and IL-17A were positively associated with AFS score(r=0.634,0.618,P<0.05).Multivariate logistic analysis showed that high levels of TNF-α(OR=3.232)and IL-17A(OR=2.798)were risk factors for severe IUA,while high levels of ED(OR=0.269),EV(OR=0.205)and VFI(OR=0.240)were protective factors(P<0.05).ROC curve showed that the AUCs for diagnosing severe IUA by ED,EV,VFI,TNF-α and IL-17A were 0.786,0.791,0.772,0.781 and 0.775 respectively,and the highest AUC(0.897)was observed when all five indicators were combined(P<0.05).Conclusion Transvaginal three-dimensional ultrasound parameters and serum TNF-α and IL-17A levels are closely related to the severity of IUA,and the combined detection of the above indicators can significantly improve the diagnostic efficiency on severe IUA.关键词
宫腔粘连/严重程度/阴道三维超声/肿瘤坏死因子-α/白细胞介素-17A/诊断价值Key words
intrauterine adhesions/severity/transvaginal three-dimensional ultrasound/tumor necrosis factor-α/interleukin-17A/diagnostic value引用本文复制引用
管珊,陈洪,郑锦燕,周依梦..宫腔粘连严重程度的诊断:基于阴道三维超声参数联合血清肿瘤坏死因子-α、白细胞介素-17A[J].分子影像学杂志,2026,49(8):1030-1036,7.基金项目
浙江省卫生健康行业科技计划项目(2025HY1511) （2025HY1511）
台州市科技计划项目(25ywb226) （25ywb226）
