经会阴四维超声结合移动手法诊断女性尿道周围囊性病变

The diagnostic value of transperineal four dimensional ultrasound combined with mobile manipulation for female periurethral cystic lesions

目的应用经会阴四维超声立体成像技术结合移动手法对女性尿道周围囊性病变进行定位定性,并探讨其对女性尿道周围囊性病变的诊断价值。方法选取2017年11月~2018年12月在遂宁市中心医院行盆底超声检查的2125例女性患者为研究对象,采用美国GE Voluson E8型彩色超声诊断仪,先用二维超声观察尿道周围囊性病变的位置、形态及其与尿道、阴道的关系,再换用腹部容积探头RAB6-D,启用四维,正中矢状面上运用四维成像后,上下移动取样框,显示尿道周围囊性病变的空间位置,从而进行定位定性诊断。结果2125例患者中,共发现尿道周围囊性病变21例,所有病例均经手术病理证实,包括尿道憩室3例,阴道壁囊肿9例,尿道旁腺囊肿8例,阴道壁脓肿1例。经会阴四维超声将本例阴道壁脓肿误诊为尿道憩室,诊断符合率为95.2%(20/21)。经阴道和会阴二维超声联合诊断,诊断阴道壁囊肿7例,尿道旁腺囊肿4例,尿道憩室1例,二维超声诊断符合率为57.1%。经会阴四维超声与经阴道和会阴二维超声联合诊断比较,差异有统计学意义(P<0.05)。结论经会阴四维超声结合移动手法,对女性尿道周围囊性病变的鉴别诊断具有重要临床价值。

Objective The transperineal four-dimensional ultrasound stereoscopic imaging combined with mobile technique was used to locately and qualitatively evaluate the diagnostic value of perineal four-dimensional ultrasound in the diagnosis of female periurethral cystic lesions. Methods From November 2017 to December 2018, 2125 female patients who underwent pelvic floor ultrasound examination in Suining central hospital were selected as the study object. GE voluson E8 color ultrasonic diagnostic instrument was used. First, the position, shape and the relationship with urethra and vagina were observed by two-dimensional ultrasound. Then, the abdominal volume probe Rab6 D was used. The four-dimensional imaging was used in the midsagittal plane. Then, the sampling frame was moved up and down to show the spatial position of the cystic lesions around urethra, so as to carry out positioning and qualitative diagnosis.Results Among the 125 cases, 21 cases were found with cystic lesions around the urethra, all of which were confirmed by operation and pathology, including 3 cases of urethral diverticulum, 9 cases of cyst of vaginal wall, 8 cases of cyst of paraurethral gland, and 1 case of abscess of vaginal wall. This case of vaginal wall abscess was misdiagnosed as urethral diverticulum by four-dimensional transvaginal ultrasound, the diagnostic accuracy was 95.2%(20/21). The combined diagnosis of transvaginal and transperineal two-dimensional ultrasound showed that there were 7 cases of cyst of vaginal wall, 4 cases of cyst of paraurethral gland and 1 case of diverticulum. There was a significant difference between transvaginal four-dimensional ultrasound and transvaginal two-dimensional ultrasound(P < 0.05).Conclusion Transperineal four-dimensional ultrasound combined with movement technique is of great clinical value in the diagnosis and differential diagnosis of female periurethral cystic lesions.