经阴道超声联合线阵高频超声诊断阴道壁囊肿的应用探讨

Application of transvaginal ultrasound combined with linear array high-frequency ultrasound in diagnosing vaginal wall cyst

目的探讨经阴道超声联合线阵高频超声检查诊断阴道壁囊肿的临床价值。方法选择31例阴道壁囊肿患者,年龄23~46岁,平均年龄35.8岁。分别单独使用经阴道超声及线阵高频超声检查进行诊断,而后将二者联合使用,分析总结阴道壁囊肿的超声图像特点,并根据术后病理及随访结果进行分析,计算二者单独使用时及联合使用时诊断准确率,比较其有无统计学差异。结果 31例阴道壁囊肿患者共39个病灶,其中20例25个病灶行囊肿切除手术治疗,术后病理类型副中肾管囊肿14个、中肾管囊肿7个、表皮包涵囊肿4个。余11例中7例行注射无水乙醇溶液治疗,4例随访观察。超声图像特点主要为：阴道壁内见类圆形或椭圆形液性区,边界多清晰,内多呈无回声,合并感染时囊腔内见密集点状回声,囊肿内部均无血流信号,部分囊壁可见少许血流显示。单独使用时,经阴道超声诊断32个病灶,诊断准确率为82.1%,线阵高频超声诊断28个病灶,诊断准确率为71.8%;二者相比较,差异无统计学意义（P〉0.05）。二者联合使用时诊断38个病灶,诊断准确率为97.4%,同单独使用相比较,差异均具有统计学意义（P〈0.05）。结论经阴道超声联合线阵高频超声检查对阴道壁囊肿的检出率及诊断准确率高于二者单独使用,有助于阴道壁囊肿的及早诊断和治疗。

Objective To estimate clinical value of transvaginal ultrasound combined with linear array high-frequency ultrasound in diagnosing vaginal wall cyst. Methods A total of 31 patients with vaginal wall cyst were enrolled, aged 23 - 46 years old with mean age of 35.8. The transvaginal ultrasound and linear array high-frequency ultrasound were performed alone and combination. The features of ultrasonic images were analyzed and summarized in combination with postoperative pathological or follow-up results. The correctly diagnostic rates were calculated for comparison the statistic difference between 2 ways. Results There were 39 focuses in 31 patients with vaginal wall cyst, 20 patients with 25 focuses performed removal cyst treatment, 7 of injection absolute alcohol treatment and 4 of followed up observation. The postoperative pathologic types were 14 paramesonephric duct cysts, 7 of mesonephric duct cysts and 4 of epidermal inclusion cysts. The main transonic image features in vaginal wall cyst were similar round or oval liquid zones with clear boundary and echoless inside. In concurrent infected, the cysts showed internal echo cloudy with rough spots, slight blood flow signals in wall lesions and no blood flow signal within the cysts. The transvaginal ultrasound and linear array high-frequency ultrasound correctly diagnosed 32 and 28 focuses performed alone, the correctly diagnostic rate respectively was 82.1% and 71.8 %, there was no statistics difference（P 〉 0.05）. In combination, 38 focuses were correctly diagnosed, and correctly diagnostic rate was 97.4 %, there was statistics difference between alone and combination performance （P 〈 0.05）. Conclusion It is demonstrated that the detection rate and diagnostic accuracy rate of transvaginal combined with linear array high-frequency ultrasound in diagnosing vaginal wall cyst are higher than performance alone, and helpful in early diagnosis and treatment of vaginal wall cyst.