Detection of Congenital Uterine Malformation by Using Transvaginal Three-dimensional Ultrasound

This study assessed the clinical application of transvaginal three-dimensional ultrasound （3D TVUS） in the diagnosis of congenital uterine malformation. A retrospective study was performed on 62 patients with congenital uterine malformation confirmed hysteroscopically and/or laparoscopically. The patients were subjected to transvaginal two-dimensional ultrasound （2D TVUS） and 3D TVUS. The accuracy rate was compared between the two methods. The accuracy rate of 3D TVUS was （98.38%, 61/62）, higher than that of 2D TVUS （80.65%, 50/62）. 3D TVUS coronal plane imaging could demon- strate the internal shape of the endometrial cavity and the external contour of the uterine fundus. It al- lowed accurate measurement on the coronary plane, and could three-dimensionally show the image of cervical tube, thereby providing information for the diagnosis of some complex uterine malformation. 3D TVUS imaging can obtain comprehensive information of the uterus malformation, and it is superior to 2D TVUS for the diagnosis of congenital uterine malformations, especially complex uterine anomaly.

三维经阴道超声评估宫内节育器位置异常及不良反应的临床研究

目的探讨三维经阴道超声评估宫内节育器(IUD)位置异常及不良反应的发生情况,指导IUD的正确选择。方法选择2016年7月至2018年2月来我院健康体检的女性志愿者作为研究对象,获取其带环时间、带环次数等信息,通过三维经阴道超声观察并记录IUD类型、位置情况等,回顾性分析不同种类型IUD位置异常、不良反应及宫颈病变的发生情况。结果 2 113例符合标准的受试者纳入研究,其中爱母环423例,圆形环506例,宫型环405例,T型环372例,γ环407例。带环后不良反应的发生率高达34.07%,不同IUD不良反应发生率不同,爱母环不良反应发生率最高,与圆形环、宫型环、T型环、γ环比较差异有统计学意义(47.99%对25.88%,27.41%,37.10%,33.66%;均P<0.05)。同一不良反应发生的IUD类型亦不同,爱母环和γ环腰痛率高于其余三种IUD,爱母环与圆形环、宫型环、T型环比较差异有统计学意义(23.4%对15.71%,14.07%,13.71%;均P<0.01)。不同类型IUD位置异常的发生率不同,圆形环下移率最高,与爱母环、γ环比较差异有统计学意义(6.32%对3.30%,3.19%;均P<0.05),与宫型环、T型环下移率差异无统计学意义(6.32%对3.45%,4.30%;均P>0.05);爱母环嵌顿率最高,与圆形环、宫型环、T型环比较差异有统计学意义(3.07%对0,0.25%,0.54%;均P<0.01)。宫型环与γ环宫内旋转率较高,与爱母环、圆形环、T型环比较差异有统计学意义(均P<0.01)。孕次>1次和带环次数≥2次均与IUD不良反应的发生有关(P<0.05)。T型环宫颈糜烂发生率最高,与爱母环、圆形环、宫型环、γ环比较差异有统计学意义(30.65%对16.78%,16.80%,18.02%,17.69%;均P<0.01)。结论女性置环后不良反应的发生率较高,不同类型IUD的不良反应和不良反应发生率均不同;不同类型IUD位置异常的发生率不同;孕次和带环次数与IUD不良反应的发生有关。