经阴道三维超声成像诊断子宫先天畸形临床应用价值研究

Clinical application value of transvaginal three dimensional ultrasound in the diagnosis of congenital uterine malformation

目的研究阴道三维超声成像诊断子宫先天畸形的临床应用价值。方法回顾性分析我院2013年5月~2016年2月的200例子宫先天畸形患者的临床资料,按照检查方式不同分为二维超声组和三维超声组,每组100例,观察两组患者的子宫内膜、外形特点及子宫畸形类型,并两组比较。结果 200例患者中,完全纵膈子宫和不完全纵膈子宫所占比例较高,分别占30.00%、28.00%。三维超声组检查结果中有完全纵膈子宫30例、不完全纵膈子宫28例、弓形子宫8例、单角子宫4例、双角子宫18例、残角子宫12例,其诊断符合率为100.00%;二维超声组中诊断结果为完全纵膈子宫30例、不完全纵膈子宫31例、弓形子宫5例、单角子宫7例、双角子宫18例、残角子宫1例,其诊断符合率为89.00%,二维超声组中将3例双子宫误诊为不完全纵膈子宫,漏诊5例单角子宫和3例残角子宫。三维超声组诊断子宫畸形类型较二维超声组更准确。结论阴道三维超声成像能够清晰显示宫腔结构以及宫底外观,对诊断子宫先天畸形诊断的准确率高,值得临床推广。

Objective： To study the clinical application value of transvaginal three-dimensional ultrasonography in the diagnosis of congenital uterine malformation. Methods： A retrospective analysis of clinical data of our hospital in May 2013 -2016 year in February 200 cases of congenital uterine malformation were examined, according to the different ways into the two-dimensional ultrasound group and three-dimensional ultrasound group, 100 cases in each group, two groups were observed in patients with endometrial appearance, characteristics and types of uterine malformations, and the comparison between the two groups. Results： In 200 cases, the total proportion of the uterus and incomplete mediastinal uterus was higher, accounting for 30% and 28% respectively. Three dimensional ultrasound examination results in the group have complete mediastinum uterus 30 cases and incomplete mediastinum uterus in 28 cases, 8 cases, 4 cases of uterine segmental unicornuate uterus, 18 cases of uterine horns, rudimentary horn of uterus in 12 cases, the diagnosis coincidence rate was 100%; two-dimensional ultrasound group diagnosis results for complete mediastinum uterus 30 cases and incomplete mediastinum uterus, 31 cases, 5 cases of uterine segmental unicornuate uterus in 7 cases, 18 cases of uterine horns, rudimentary horn of uterus in 1 cases, the diagnosis rate was 89%, 3 cases of two-dimensional ultrasound group, double uterus misdiagnosed as incomplete mediastinum uterus, 5 cases were misdiagnosed and single uterine horn 3 cases of rudimentary uterine horn. Three dimensional ultrasound group was more accurate in the diagnosis of uterine malformation than two-dimensional ultrasound group. Conclusion： Three dimensional ultrasound imaging can clearly show the structure of the uterine cavity and the appearance of the bottom of the uterus, which is of high accuracy in the diagnosis of congenital uterine malformation, which is worthy of clinical application.