经阴道三维超声诊断子宫肌壁间妊娠的价值

Value of transvaginal three-dimensional ultrasonography in the diagnosis of intramural pregnancy of uterus

目的探究经阴道三维超声诊断子宫肌壁间妊娠的临床价值,为早期临床诊断中提高治疗效率提供借鉴依据。方法选取2018年4月到2019年1月台州医院诊治的3例疑似子宫肌壁间妊娠患者作为研究对象。先后使用阴道二维超声及阴道三维超声进行诊断,后根据临床病理实证回顾分析,比较两种超声检查的声像图特征、分型诊断效能及诊断结果的准确率,分析经阴道三维超声诊断的临床价值。结果对经阴道二维超声及阴道三维超声诊断的图像特征进行比较,两种超声诊断方式在附件异常、是否有其他异常等方面的图像显示相似,经阴道三维超声检查结果对包块离肌层厚度的判断更加精确。阴道二维超声对子宫肌壁间妊娠存在漏诊情况。在分型判断方面,与手术病理相符者,阴道二维超声1例,阴道三维超声2例。结论阴道三维超声对子宫肌壁间妊娠进行诊断,声像图呈现更加清晰直观,对病理的诊断分型有更高的应用价值,为早期采取医疗措施提供依据,值得推广。

Objective To explore the clinical value of transvaginal three-dimensional ultrasonography in the diagnosis of intramural pregnancy of uterus,in order to provide reference for improving the diagnostic efficiency of clinical diagnosis.Methods Three cases of suspected intramural pregnancy of uterus treated in Taizhou Hospital from April 2018 to January 2019 were selected as the study subjects.Transvaginal two-dimensional and three-dimensional ultrasonography were performed successively.According to the clinical and pathological evidence,the sonographic characteristics,classification diagnostic efficiency and diagnostic accuracy of the two kinds of ultrasound were compared,and the value of transvaginal three-dimensional ultrasonography was analyzed.Results The image features of transvaginal two-dimensional and three-dimensional ultrasonography were compared.The images of accessory abnormality and other abnormalities were similar between the two methods.The results of transvaginal three-dimensional ultrasonography were more accurate to judge the thickness of the muscle layer.Missed diagnosis was found in transvaginal two-dimensional ultrasonography.In terms of pathological diagnosis and classification,there was a case confirmed by two-dimensional ultrasonography and two cases confirmed by three-dimensional ultrasound.Conclusions Transvaginal three-dimensional ultrasonography is of the advantages of clear and intuitive ultrasonogram and higher application value for pathological diagnosis and classification in the diagnosis of intramural pregnancy of uterus,which can provide basis for early medical intervention and worthy of popularizing.