子宫输卵管碘油造影在先天性子宫畸形诊断及分型中的临床应用

Application of hysterosalpingography in diagnosis and typing of congenital uterine anomalies

目的探讨子宫输卵管造影(HSG)诊断先天性子宫畸形及其分型的临床价值。方法选择经宫腔镜联合腹腔镜证实的65例先天性子宫畸形患者,回顾性分析HSG检查时子宫、输卵管以及盆腔的X线表现。结果 65例患者经HSG诊断:不全纵隔子宫22例,完全纵隔子宫15例,双子宫12例,双角子宫8例,单角子宫5例,始基子宫3例,正常子宫0例。65例中误诊3例,诊断符合率为95.2%,其中将不全纵隔子宫误诊为双子宫2例,完全纵隔子宫误诊为双角子宫1例。子宫畸形类型中不全纵隔子宫、完全纵隔子宫和双子宫的比例较高。结论 HSG可以直观显示子宫轮廓及宫腔形态,在鉴别诊断双角子宫、单角子宫和双子宫方面的效果尤其明显,在先天性子宫畸形诊断及分型中具有重要的参考价值。

Objective： To evaluate the clinical value of Hysterosalpingography（HSG） in the diagnosis and typing of congenital uterine anomalies.Methods： A total of 65 women with evidence of uterine anomalies were enrolled.Laparoscopic and / or hysteroscopic assessment were used as the standard for final diagnosis.Retrospective analysis of 65 participants who had routine hysterosalpingography in the features of HSG about the uterus,the fallopian tube and the pelvis.Results： A total of 65 uterine anomalies were classified： 22 cases of subseptate uterus,15 cases of septate uterus,12 cases of didelphia,8 case of bicomuate uterus,5 cases of unicomuate uterus,1 case of primordial uterus and 0 cases of normal uterus.The misdiagnosed cases were 3（3 /65）.Compared with hysteroscopy and / or laparoscopy,the diagnosis accordance rate of HSG was 95.2%.Subseptate uterus was misdiagnosed as didelphia,septate uterus was misdiagnosed as bicomuate uterus,and Subseptate uterus,septate uterus and arcuate uterus were the most common types in congenital uterine anomalies.Conclusions： Both the shape of cavity and the outline of uterus can be shown more clearly by HSG,which has more accurate diagnose of septate uterus,arcuate uterus,and bicomuateuterus.HSG plays an important role in the diagnosis and typing of congenital uterine anomalies.