三维超声在早孕期残角子宫妊娠诊断中的应用价值

Application of three dimensional ultrasound in diagnosis of rudimentary uterine horn pregnancy in first trimester

目的探讨三维超声在早孕期残角子宫妊娠诊断中的应用价值,以期提高残角子宫妊娠的诊断准确性。方法对我院收治的5例早孕期残角子宫妊娠患者的临床表现、二维及三维超声声像图特征及手术病理诊断结果进行总结分析。结果 5例患者均无阴道出血表现,其中1例轻度腹痛,经腹部超声检查提示为双子宫,右侧子宫内妊娠;4例患者无明显腹痛,其中1例经阴道超声检查提示为异位妊娠,子宫外包块;其余3例经腹部及经阴道超声检查结合三维超声子宫冠状切面成像检查显示子宫均呈"单角状",子宫外包块提示诊断为残角子宫妊娠。5例患者均行残角子宫及患侧输卵管切除,手术病理检查证实均为残角子宫妊娠。结论经腹部及经阴道超声结合三维超声检查可提高早孕期残角子宫妊娠诊断的准确性,从而预防残角子宫妊娠破裂及出血等不良后果的发生。

ObjectiveTo explore the application of three-dimensional ultrasound(3DUS)in the diagnosis of rudimentary uterine horn pregnancy in first trimester,and to improve the diagnostic accuracy in rudimentary uterine horn pregnancy. MethodsThe clinical,ultrasonographic and operative findings of 5 patients who were diagnosed with rudimentary uterine horn pregnancy in first trimester were analyzed.Results All the 5 patients had no history of vaginal bleeding.One patient had mild abdominal pain,transabdominal ultrasound showed uterus duplex and the intrauterine pregnancy in the right uterine.The rest 4 patients had no abdominal pain.Among them, a case of ectopic pregnancy with unilateral adnexal mass was found on transvaginal ultrasound examination.In the remaining 3 cases,transabdominal or transvaginal ultrasound combined with three-dimensional ultrasound showed a single angular uterus on coronal plain and a unilateral adnexal mass suggestive of ectopic pregnency.All 5 patients underwent surgical treatment and were diagnosed as rudimentary uterine horn pregnancy.ConclusionCombination of transabdominal or transvaginal and 3DUS can increase the diagnostic accuracy for rudimentary uterine horn pregnancy,and avoid adverse events,such as rudimentary uterine rupture and haemorrhage.