三维超声C平面在先天性子宫畸形诊断及分型中的应用

Application of Three-Dimensional Ultrasound C Plane in Diagnosis and Typing of Congenital Uterine Anomalies

目的:评价三维超声C平面成像诊断先天性子宫畸形及其分型的临床价值。方法:采用经阴道或直肠三维超声对二维超声疑为子宫畸形的97例患者进行检查,通过三维超声C平面成像进行诊断,并与二维超声诊断结果和宫腔镜和(或)腹腔镜的诊断结果进行比较。结果:97例患者经三维超声诊断:不全中隔子宫25例,完全中隔子宫20例,双子宫2例,双角子宫1例,弓形子宫23例,单角子宫合并残角子宫5例,X型中隔子宫7例,双侧始基子宫1例,正常子宫13例(其中1例为宫腔中央部分粘连)。子宫畸形类型中不全中隔子宫、完全中隔子宫和弓形子宫的比例较高。三维超声与宫腔镜和(或)腹腔镜的诊断符合率为100%,而二维超声诊断符合率只有51%。结论:三维超声C平面成像可以直观显示子宫轮廓及宫腔形态,在鉴别诊断中隔子宫、弓形子宫和双角子宫方面的效果明显优于二维超声,在先天性子宫畸形诊断及治疗中具有重要的参考价值。

Objective：To assess the accuracy and clinical value of three-dimensional （3D） ultrasound in the diagnosis and typing of congenital uterine anomalies.Methods：A total of 97 patients,suspected of uterine anomalies by transvaginal or transrectal two-dimensional （2D） ultrasound,underwent 3D ultrasound on coronal plane（C plane）,and the results of the two ultrasonic methods were compared with the results of laparoscopic and/or hysteroscopic assessment.Results：With 3D ultrasound we diagnosed： 25 cases of subseptate uterus,20 cases of septate uterus,2 cases of didelphia,1 case of bicornuate uterus,23 cases of arcuate uterus,5 cases of unicornuate uterus and rudimentary horn,7 cases of a special type of uterus septus （X type endometrium）,1 case of bilateral primordial uterus,and 13 cases of normal uterus（1 case was central adhesion of uterine cavity）.Subseptate uterus,septate uterus and arcuate uterus were the most common types in congenital uterine anomalies.Compared with hysteroscopy and/or laparoscopy,the diagnosis accordance rate of 3D ultrasound was 100%,which was much higher than that of 2D ultrasound （51%）.Conclusions：Compared with 2D ultrasound,both the shape of cavity and the outline of uterus can be shown more clearly by C plane of 3D ultrasound,which has more accurate diagnose of septate uterus、arcuate uterus、and bicornuateuterus.3D ultrasound plays an important role in the diagnosis and treatment of congenital uterine anomalies.