经阴道二维及三维超声诊断先天性子宫畸形的对比分析

Comparative Study of Transvaginal Two-dimensional and Three-dimensional Ultrasound in Diagnosis of Congenital Uterine Anomalies

目的:对经阴道二维及三维超声获得的先天性子宫畸形声像图资料进行对比分析,探讨两者对子宫畸形的诊断价值。方法收集2007年7月到2011年12月经阴道二维及三维超声诊断的152例先天性子宫畸形患者的二维及三维超声图像,以子宫输卵管造影联合宫腔/腹腔镜检查结果为金标准,对比分析两者的声像图表现及诊断符合率。结果:152例患者中,二维、三维诊断结果分别为:子宫发育不良(3/3),单角子宫(1/3),残角子宫(2/2),双角子宫(12/12),鞍形子宫(24/19),纵隔子宫(101/93),双子宫(7/7),正常子宫(2/13)。三维超声诊断符合率为100%,二维超声为90.1%(P=0.000)。结论:经阴道二维超声是子宫畸形检查的基础,但有漏诊、误诊。采用子宫冠状切面三维超声成像能够得到子宫发育异常的准确信息,提高诊断符合率。

Objective To compare the efficiency of transvaginal three-dimensional（3D） and two-dimensional （2D） ultrasound in diagnosis of congenital uterine anomalies. Methods From July, 2007 to December, 2011, sonographic data of 152 cases diagnosed of congenital uterine anomalies by transvaginal 2D or 3D ultrasound were analyzed retrospectively. The results of these two methods were compared using hysterosalpingogaphy combined with hysteroscopy/celioscopy as gold standard. Results Diagnosis of 3D/2D ultrasound were： infantile uterus （3/3）. unicornuate uterus （1/3）. rudimentary horn of uterus （2/2）. bicornuate uterus （12/12）, uterus arcuatus （24/19）. uterus septus（101/93）, didelphia（7/7）, normal uterus（2/13）. Diagnose accordance rate of 3D and 2D ultrasound were 100% and 90.1% respectively（P=0.000）. Conclusion Transvaginal 2D US is foundational examination for congenital uterine anomalies, bur missed diagnosis and misdiagnosis occur sometimes. Transvaginal 3D US can provide accurate diagnostic information for congenital uterine anomalies and improve the diagnostic accordance rate.