超声对先天性阴道斜隔综合征的诊断价值

Diagnostic value of ultrasonography in congenital vaginal reclined septum syndrome

目的探讨超声对先天性阴道斜隔综合征(CVRS)的诊断价值。方法回顾性分析2008年1月至2013年11月期间经浙江大学医学院附属妇产科医院手术及病理确诊的45例CVRS患者的临床资料。结果 45例CVRS临床表现为腹痛23例,阴道淋漓出血8例,阴道流脓4例,进行性痛经3例,无明显症状者7例。超声检查结果:①子宫畸形:45例均提示子宫畸形,其中双子宫29例,完全纵隔子宫11例,不完全纵隔子宫1例,单角子宫合并残角子宫2例,双角子宫2例;②宫腔积血或囊性包块:一侧宫腔或宫颈积血者23例,一侧宫体下方囊性包块36例,可见囊性包块对侧正常阴道及与阴道相连的子宫6例;③泌尿系统:伴肾脏缺如或发育不良有42例,双肾正常1例,肾脏情况不明2例。结论 CVRS具有典型超声图像表现,超声诊断CVRS准确率高,术前确诊率高达93.33%,可为临床提供重要诊断价值。

Objective To investigate the value of ultrasonography in the diagnosis of congenital vaginal reclined septum syndrome （ CVRS） .Methods Retrospective analysis was conducted on the clinical data of 45 women with CVRS confirmed by surgery and pathology . They were admitted in Obstetrical and Gynecological Hospital of Medical College of Zhejiang University from January 2008 to November 2013.Results Of 45 cases with CVRS, 23 cases had the manifestation of abdominal pain , 8 cases had intermittent vaginal bleeding , 4 cases had vaginal discharge , and 3 cases had progressive dysmenorrhea .The rest 7 cases had no obvious symptoms .Ultrasound images revealed uterine malformation in 45 cases, including 29 cases of gemini, 11 cases of complete mediastinum uterus , 1 case of incomplete mediastinum uterus , 2 cases with single angle combining with residual angle uterus , and 2 cases of uterus bicornis .There were 23 cases with uterine cavity or cervical hemorrhage , and 36 cases with cystic mass below uterus body on one side .Normal vagina and uterus on contralateral side of cystic mass were found in 6 cases.There were 42 cases complicating with kidney deficiency or dysplasia , 1 case with normal kidneys and 2 cases with unknown kidney situation .Conclusion CVRS has typical ultrasonic image manifestations .The accurate rate of ultrosonography for CVRS is high , and it reaches 93.33%before surgery, which can provide important diagnostic value for clinics .