经会阴超声联合腔内容积超声诊断先天性子宫及阴道畸形的价值

The value of transperineal ultrasound combined with intracavitary volume ultrasound in the diagnosis of congenital uterine and vaginal malformation

目的探讨经会阴超声联合腔内三维容积超声诊断先天性子宫及阴道畸形的价值。方法回顾性分析2018年1月~2020年3月在徐州市妇幼保健院诊断为先天性子宫及阴道畸形的183例患者,分别按照单纯经腹部或经腔内二维超声检查和经会阴超声联合腔内容积超声两种检查方式将其分为A、B两组。A组为单纯经腹部或经腔内二维超声检查诊断为先天性子宫及阴道畸形的83例患者。B组为经会阴超声联合腔内容积超声检查的100例,且采用四节段诊断方法对B组患者进行综合诊断。比较分析A、B两组患者的超声诊断结果及最终临床结局。结果A组单纯经腹部或经腔内超声检查诊断的符合率为84.3%(70/83),漏、误诊13例。B组经会阴超声联合腔内容积超声诊断符合率达95.0%(95/100),漏、误诊5例。B组较A组对先天性子宫及阴道畸形的定性及分类诊断更详细和准确(χ^2=5.814,P<0.05)。结论应用经会阴超声联合腔内容积超声,同时采用四节段分析的诊断方法可大大提高先天性女性生殖道畸形的定性及分类诊断的准确率。

Objective To explore the value of transperineal ultrasound(TPU)combined with intracavitary three-dimensional volume ultrasound in the diagnosis of congenital uterine and vaginal malformation.Methods A retrospective analysis was made on 183 patients diagnosed with congenital uterine and vaginal malformation in Xuzhou Maternity and Child Health Care Hospital from January 2018 to March 2020.They were divided into group A and group B respectively according to the two methods of merely transabdominal or intracavitary two-dimensional ultrasound examination and TPU combined with intracavitary volume ultrasound examination.Group A consisted of 83 patients diagnosed with congenital uterine and vaginal malformation by merely transabdominal or intracavitary twodimensional ultrasound examination.Group B consisted of 100 patients examined by TPU combined with intracavitary volume ultrasound,and the patients of group B were comprehensively diagnosed by four-segment diagnostic method.The ultrasonic diagnosis results and final clinical outcomes of the patients in group A and group B were compared and analyzed.Results The diagnostic coincidence rate of group A was 84.3%(70/83)by merely transabdominal or intracavitary ultrasound examination,with 13 cases of missed diagnoses and misdiagnoses.The diagnostic coincidence rate of group B was 95.0%(95/100)by transperineal ultrasound combined with intracavitary volume ultrasound,with 5 cases of missed diagnoses and misdiagnoses.The qualitative and classified diagnosis of congenital uterine and vaginal malformation in group B was more detailed and accurate than that in group A(χ^2=5.814,P<0.05).Conclusion The application of the diagnostic method of TPU combined with intracavitary volume ultrasound plus four-segment analysis can greatly improve the accuracy of the qualitative and classified diagnosis of congenital female genital tract malformation.