经阴道超声诊断剖宫产术后子宫切口憩室的临床价值

Clinical value of transvaginal ultrasound in diagnosis of cesarean scar diverticulum after cesarean section

目的探讨经阴道超声检查对剖宫产术后子宫切口憩室的诊断价值。方法对剖宫产术后临床怀疑切口处憩室的50例患者行经阴道超声检查,检查过程中观察切口处有无憩室,测量憩室大小及其最薄肌层厚度,检查后1个月内均进行宫腔镜检查,以宫腔镜检查发现憩室作为诊断标准。结果宫腔镜发现憩室45例,经阴道超声检查发现憩室40例,与宫腔镜相比,经阴道超声检查诊断憩室的符合率为90.00%,灵敏度为88.89%,特异度为100.00%,漏诊率为11.11%。经阴道超声检查测量憩室大小为上下径(9.17±2.63)mm、左右径(11.76±5.67)mm、高度(5.62±2.13)mm,最薄肌层厚度(3.29±1.01)mm。结论经阴道超声检查能够较好的发现子宫切口处憩室并能够对憩室大小、肌层厚度进行准确测量,是一种诊断切口处憩室无创、便捷的检查方法。

Objective To investigate diagnostic value of transvaginal ultrasound for cesarean scar diverticulum after cesarean section. Methods Transvaginal ultrasound was taken by 50 patients with suspected scar diverticulum after cesarean section. Scar diverticulum was observed, and diverticulum size and the thinnest muscular thickness were detected. All patients received hysteroscope examination after 1 month, and hysteroscopic outcome was taken as diagnosis standard. Results There were 45 cases with diverticulum detected by hysteroscope and 40 cases by transvaginal ultrasound. Comparing with hysteroscope, transvaginal ultrasound in diagnosing diverticulum showed coincidence rate as 90.00%, sensitivity as 88.89%, specificity as 100.00% and misdiagnosis rate as 11.11%. Transvaginal ultrasound showed vertical diameter of diverticulum as（9.17±2.63） mm, transversal diameter as（11.76±5.67） mm, height as（5.62±2.13） mm and the thinnest muscular thickness as（3.29±1.01） mm. Conclusion As an non-invasive and convenient examination way in diagnosis of scar diverticulum, transvaginal ultrasound can detect cesarean scar diverticulum and measure diverticulum size and muscular thickness with good accuracy.