对比分析三维超声对子宫畸形诊断的临床价值

Evaluation of Three-dimensional Ultrasound in diagnosis of congenital Uterine anomalies

目的对比二维与三维经腹或经阴道超声对子宫畸形诊断结果,评价三维超声诊断子宫畸形临床价值。方法对二维诊断子宫畸形或疑诊子宫畸形131病例,进行相应三维超声扫查,对诊断结果进行分类比较,总结二者区别所在。部分接受核磁检查及宫腔镜手术和碘油造影的病例对其超声检查结果进行比较。结果三维超声明确诊断131例子宫畸形,其中在二维扫查可获得明确诊断121例,2例单角有内膜无残角子宫二维超声未得到明确诊断,1例单角子宫有残角有内膜被诊断为不全纵隔子宫,2例弓形子宫被二维超声诊断为正常子宫,1例双角子宫和2例弓形子宫被诊断为不全纵隔子宫。19例纵隔子宫核磁或宫腔镜手术证实,4例单角子宫中2例宫腔镜及腹腔镜联合手术、2例外院输卵管碘油造影证实,与3D超声符合率达100%;19例纵隔子宫2D超声诊断18例,4例单角子宫2D超声均未诊断。结论二维超声诊断双子宫及完全纵隔子宫多无困难,较少见先天子宫畸形:如单角子宫,易发生漏诊或误诊。三维超声能够得到子宫冠状切面成像,能更准确诊断子宫先天发育异常,易于区分不全纵隔子宫、双角子宫、弓形子宫及单角子宫。

Objective Compared the result of two - dimensional and three-dimensional （3D） ultrasound in diagnosis of congenital uterus anomalies. To evaluate the value of 3D Ultrasound. Methods 131women diagnosed with uterine malformation or suspected by 2D ultrasound,3D US was performed in 131cases.77 cases by transabodomal,54 cases by transvaginal. All cases by careful gynecolog- ical exploration. Results U sing 3D ultrasound we diagnosed： 25 with didelphic uterus, 68 partial septate uterus, 24 subseptate uterus, 4 unicornuste uterus,4 bicornuste uterus, 6 arcuate uterus, l unicornuate uterus and 2 arcnate uterus diagnosed as normal uterus by 2D ultrasound. 1 unicoruuate uterus with endomerium diagnosed as partial septate and 1 bicornuate uterus and 2 arcuate uterus diagnosed as partial septate uterus. 19 septate uterus and 4 bicornuste uterus cases confirmed by magnetic resonance imaging and hysteroscopic and laparescopic surgery and tubal lipiodol angiography. 23 cases of uterine malformations 3 D ultrasound diagnosis rate of 100 %., 2D ultrasound diagnosis rate of 78.2%. Conclusion Compared with 2D ultrasound, 3D Ultrasound have a high accuracy, differed the partial septate uterus with unicornuate uterus and arcuate uterus, because the relationship between cavity and fundus being visualized well with 3D ultrasound.