磁共振成像对单角子宫畸形的诊断价值分析

The analysis of value of MRI in diagnosis of unicornuate uterine malformation

目的探讨MRI对单角子宫畸形的诊断价值。方法选取分析77例单角子宫畸形患者的MRI和三维超声(3DUS)资料,以ESHRE-ESGE共识为分类依据,以内镜及手术病理结果为金标准,比较MRI与3DUS对单角子宫畸形分型及常见并发症的诊断价值。结果与内镜及病理结果的一致性比较,MRI及3DUS的Kappa值分别为0.76、0.62,两种检查方法都具有较高的一致性(P<0.05),对单角子宫畸形分型的诊断符合率MRI为88.24%,3DUS为81.82%,两者比较差异无统计学意义(P>0.05)。其中35例出现并发症,MRI对子宫腺肌症的检出率高于3DUS,且差异有统计学意义(P<0.05);对泌尿系统畸形、残角子宫妊娠及子宫内膜异位囊肿的确诊率,两种检查方法差异无统计学意义。结论MRI与3DUS对单角子宫畸形均具有较高的诊断价值;MRI多序列成像,软组织分辨率高,对相关并发症的显示优于3DUS,能够为临床治疗提供更多确诊依据。

Objective To explore the value of magnetic resonance imaging(MRI)in diagnosis of unicornuate uterine malformation.Methods MRI and Three-dimensional ultrasound(3DUS)data of 77 patients with unicornuate uterine malformation were retrospectively analyzed.Based on ESHRE-ESGE consensus,taking endoscopic and surgical pathological results as golden standard,the diagnostic value of MRI and 3DUS in the classification and complications of unicornuate uterine malformation were compared.Results Compared with endoscopic and surgical pathological results,the Kappa values of MRI and 3DUS were 0.76 and 0.62,respectively.The two examination methods were highly consistent(P<0.05).The diagnostic coincidence rate of unicornuate uterine malformation was 88.24%on MRI and 81.82%on 3DUS,and there was no significant difference between them(P>0.05).Among them,35 cases had complications,and the diagnostic accuracy of adenomyosis by MRI was higher than that by 3DUS,and the difference was statistically significant(P<0.05).There was no significant difference in the diagnosis rate of urinary system malformation,residual horn pregnancy and endometrial implantation cyst.Conclusion Both MRI and 3DUS have high diagnostic value for unicornuate uterine malformation.MRI with multi-sequences imaging and high soft tissue resolution can show related complications better than 3DUS,which can provide more evidence for clinical treatment.