子宫内膜结核在宫腔镜下的图像特征

Imaging features of endometrial tuberculosis dunder hysteroscope

目的正确识别子宫内膜结核宫腔镜下图像特征,提高该病的诊断准确率。方法回顾性分析2002年1月～2008年12月在我院行宫腔镜检查并经病理确诊为子宫内膜结核的宫腔镜图像。结果确诊的19例患者中不孕症13例,月经过多1例、月经过少8例、继发性闭经3例,绝经后子宫出血3例、绝经后宫腔排液1例,3例慢性盆腔痛。4例有结核病的一般表现,4例曾患肺结核和/或颈淋巴结结核。宫腔镜下基本图像特征:4例患者子宫内膜增厚,表面见粟粒状小结节。5例患者子宫内膜消失,表面覆盖一层厚的苍白的绒毛状或丝状的质脆组织,无异形血管。10例患者内膜瘢痕化,宫腔呈不同程度狭窄。结论子宫内膜结核可造成宫腔破坏而导致不孕、月经过少、闭经,子宫内膜结核有典型的宫腔镜下特征,定位活检可提高确诊率。

Objective To evaluate the hysteroscopic findings in endometrial tuberculosis （TB）. Methods A total of 19 female endometrial tuberculosis patients underwent diagnostic hysteroscopy and confirmed by endometrial histopathologic studies were enrolled in this retrospective study in our hospital from January 2002 to December 2008. Results Of the 19 cases there were 13 infertility,l menorrhagia,8 hypomenorrhea,3 secondary amenorrhea, 3 postmenopausal bleeding ,1 Postmenopansal vaginal discharge and 3 chronic pelvic pain. There were 4 cases presented the symptoms of TB.. Tubercles on thickened endometrium was observed in 4 eases and pale shaggy cavity with caseation was observed in 5 cases and uterine adhesions was observed in 10 cases. Conclusion Endometrial tuberculosis presents typical characteristics at hysteroscopy with pointed endometrial biopsy.