三维冠状切面成像在子宫畸形诊断中的应用  

Application value of three-dimensional coronal section image in the diagnosis of uterine malformation

作　　者：吴锡金[1] 甘柏柳[1] 陈桂荣[1] 黄玉葵[1] 梁凤玲[1] 阮俏梅[1] 潘华[1] 

机构地区：[1]广西南宁市妇幼保健院超声科,南宁市530011

出　　处：《微创医学》2009年第2期101-103,F0004,共4页Journal of Minimally Invasive Medicine

基　　金：广西卫生厅科研课题(编号E2007349)

摘　　要：目的探讨三维彩超成像技术在子宫畸形诊断中的应用价值。方法对临床拟诊子宫畸形的病例进行二维超声扫查,同时行三维冠状切面成像,诊断为子宫畸形后进行宫、腹腔镜检查证实,对子宫畸形合并早期妊娠者行人流术确诊,对照二者子宫畸形诊断灵敏度。结果超声共诊断子宫畸形188例,施行宫腔镜或宫腹腔镜联合检查确诊26例,二维超声诊断符合16例,误诊3例,漏诊7例;三维彩超冠状切面成像诊断符合24例,误诊2例。二维超声诊断灵敏度61.53%,三维超声诊断灵敏度92.31%;人流术确诊子宫畸形合并早期妊娠41例,二维诊断符合32例,三维符合41例。二维超声诊断的灵敏度78.04%,三维超声诊断灵敏度100%。三维超声诊断子宫畸形敏感性优于二维超声(均P<0.05)。结论三维超声能够对子宫冠状面成像,其敏感性优于二维超声,尤其是对子宫畸形合并妊娠者较二维超声诊断更为准确,是诊断子宫先天性发育异常的最佳手段。Objective To explore the application value of three-dimensional coronal section image technology in the diagnosis of uterine malformation. Methods Patients suspected of uterine malformation were checked with two-dimensional ultrasound and three-dimensional coronal section image and verified with hysteroscopy and laparoscopy and performed with induced abortion if combined with pregnancy. The sensitivity rate of two-dimensional ultrasound and three-dimensional coronal section image were calculated and compared. Results 188 were diagnosed with uterine malformation by two-dimensional ul- trasound and three-dimensional coronal section image. Of 26 uterine malformation patients verified with hysteroscopy and lap- aroscopy, 16 were in accordance with the results of transvaginal two-dimensional ultrasound,3 were misdiagnosed, and 7 were missed, for those by three-dimensional coronal section image,24 were in accordance, and 2 diagnosis were misdiagnosed;the diagnosis sensitivity rates of uterine malformation by two-dimensional and three-dimensional ultrasounds were 60.86% and 91.3% ,respectively. Of 41 diagnosed and undergo induced abortion because of uterine malformation complicated with early pregnancy ,32 were diagnosed correctly by transvaginal two-dimensional ultrasound and 41 by three-dimensional color Doppler image, namely the diagnosis sensitivity rates of uterine malformation by two-dimensional and three-dimensional ultrasounds were 78.04% and 100% ,respectively ,suggesting a superiority of three-dimensional ultrasounds in the diagnosing of uterine malformation （all P〈0.05）. Conclusions The three-dimensional ultrasound can develop an image for the coronal section of uterus ,which is superior to that of two-dimensional ultrasound. The three-dimensional ultrasound is more accurate than the two-dimensional one in diagnosing uterine malformation complicated with pregnancy, and is suggested as the best means for the diagnosis of congenital uterine dysplasia.

关 键 词：三维冠状切面成像 二维超声 子宫畸形 宫腔镜 腹腔镜 人流术 

分 类 号：R711.1[医药卫生—妇产科学]