经阴道彩色多普勒超声诊断流产后宫腔残留物的意义

Significance of intrauterine residue diagnosed by transvaginal color Doppler after abortion

目的探讨经阴道彩色多普勒超声诊断流产后宫内残留物的临床意义。方法运用经阴道彩色多普勒超声血流显像诊断宫内残留物89例，了解子宫内情况及子宫腔周围肌壁血流情况，检测动脉阻力指数（ resistance index, RI ）值，并和清宫后病理结果对照。结果89例宫内残留物全部经清宫术后病理证实，经阴道彩色多普勒超声诊断准确率100％。彩色多普勒血流显像（ Color Doppler Flow Imaging, CDFI ）：54例（占60％）检测到残留物基底部或近子宫腔局部有较为丰富血流信号，无血流信号31例（占34．8％），脉冲多普勒（Pulsed wave Doppler，PW）呈类滋养层血流频谱，RI值为0．40—0．60。结论经阴道超声结合CDFI能较清楚地观察到子宫内的异常血流情况，在宫腔内异常回声团块内部、基底部与局部子宫壁内检测出局灶性血流，并测得低阻力血流频谱，因此能更准确、更及时地为临床医生提供很有价值的诊断依据。

Objective To discuss the clinical value of intrauterine residue diagnosed by transvaginal color Doppler after abortion. Methods 89 patients were confirmed of intrauterine residue with blood flow imaging by transvaginal color Doppler which could offer also a better understanding of their intrauterine state and the state of blood flow in uterine muscular layer. Meanwhile the values of resistance index （ RI ） were measured and all of these results were compared with the pathological results from suction curettage. Results All 89 cases were path- ologically confirmed to be intrauterine residue after suction curettage. The rate of diagnostic accuracy of transvaginal color Doppler was 100 %. Color Doppler Flow Imaging （ CDFI ） ： there were rich signals of blood flow around the basilar part of the residue or on local site near uterine cavity in 54 cases, accounting for 60%. Among another 31 cases accounting for 34.8% there were no signals of blood flow and the trophoblast - like blood flow was detected by pulsed wave Doppler （ PW ）. Resistance index （ RI ） of them was 0.40 - 0.60. Conclusion The abnormality in trophoblast - like blood flow could be observed rather clearly with eombinative application of transvaginal color Doppler and CDFI. The abnormal echoic area intrauterine and focal blood flow in basilar part of the residue and on local site near uterine wall were detected as well as the blood flow with low resistance. Therefore, the valuable basis could be provided to clinical doctors more timely and accuracy.