实时三维超声诊断女性尿瘘的影像学方法

Imaging method by real-time three-dimensional ultrasound in diagnosis of female urinary fistula

目的探讨实时三维超声诊断女性尿瘘的影像学方法。方法应用实时三维超声检查42例女性尿瘘患者,分别经腹部及会阴部观察女性膀胱-阴道间隔、尿道-阴道间隔矢状面和横断面的超声声像图表现,观测瘘口位置和大小,并作排尿试验或从尿道注入有色液体试验来证实。结果 42例均可显示膀胱壁、尿道、阴道、膀胱-阴道间隔、尿道-阴道间隔全程矢状面及不同水平横断面的声像图,瘘口处均显示膀胱-阴道或者尿道-阴道局部融合,间隔组织缺失,回声中断,排尿试验或从尿道注入有色液体试验证实瘘口存在,术后验证位置及大小。结论实时三维超声检查女性尿瘘,通过女性膀胱-阴道间隔、尿道-阴道间隔在不同水平横断面及矢状面的超声表现,诊断和测量瘘口,结合病史及排尿试验或从尿道注入有色液体试验,对女性尿瘘临床诊断、治疗有重要作用。

Objective To investigate imaging method by real-time three-dimensional ultrasound in diagnosis of female urinary fistula. Methods Real-time three-dimensional ultrasound was applied for examination in 42 female patients with urinary fistula. Ultrasound images of sagittal plane and transverse plane of bladder-vagina interval and urethra-vagina interval through abdomen and perineum. Position and size of orificium fistulae were observed and verified by voiding trial or injection of colored liquid through urethra. Results All the 42 cases had images of full sagittal plane and partial transverse plane of bladder wall, urethra, vagina, bladder-vagina interval and urethra-vagina interval. Orificium fistulae all had meromixis of bladder- vagina or urethra-vagina, deficiency of interval organization, and suspended echo. Voiding trial or injection of colored liquid through urethra verified existence of orificium fistulae, and position and size were verified by operation. Conclusion Implement of real-time three-dimensional ultrasound provides important effects in clinical diagnosis and treatment of female urinary fistula through diagnosis of orificium fistulae by ultrasound manifestations of sagittal plane and transverse plane of bladder-vagina interval and urethra-vagina interval, combined with medical history and voiding trial or injection of colored liquid through urethra.