经阴道三维超声反转成像对输卵管积水的诊断价值  

Value of three-dimensional transvaginal ultrasound inversion rendering technique in diagnosis of hydrosalpinx

作　　者：于利利[1] 张璇[1] 章婷[1] 陈汉荣[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院妇产科武汉协和医院妇产科,湖北武汉430022

出　　处：《医学影像学杂志》2016年第1期81-83,共3页Journal of Medical Imaging

摘　　要：目的探讨经阴道三维超声反转成像模式诊断输卵管积水的声像图表现及临床实用价值。方法选取我院2011年1月-2011年12月住院的51例输卵管积水患者的超声声像图资料进行回顾性分析。当探及卵巢周边腊肠样或迂曲的无回声结构,获取满意二维图像后,测量包块大小。然后启动三维重建,将容积框包绕无回声区,进行自动容积扫查,调整X,Y,Z轴及切割线,获得含三个切面（矢状面、冠状面和横切面）的空间立体图像,使用三维反转成像模式。结果经腹腔镜手术证实51例均为输卵管积水。临床妇科检查扪及包块29例。术前经阴道彩色多普勒超声诊断39例,误诊为卵巢囊肿8例,误诊为卵巢冠囊肿2例,漏诊2例。诊断正确率为76%。经阴道三维超声诊断48例,误诊为卵巢囊肿2例,误诊为卵巢冠囊肿1例。诊断正确率为94%。阴道三维检查48例患者中有13例为双侧输卵管积水,35例为单侧输卵管积水。部分患者合并子宫肌瘤5例,子宫腺肌症7例,卵巢囊肿11例,盆腔积液51例。结论阴道三维超声反转成像模式不仅能提供二维超声的检查信息,还能更全面立体的显示输卵管积水的大小、迂曲形态及走向、内部结构及周围脏器的关系,弥补了二维超声的不足。Objective To evaluate the sonographic appearance and clinical practical value of using three-dimensional （3D） transvaginal ultrasound Inversion Rendering Technique in dingnosos of hydrosalpinx. Methods A cohort of 51 hospitalized patients with hydrosalpinx confirmed by laparoscopic surgery from January 2011 to December 2011 were analyzed. The patients were scanned with two-dimensional （2D） and 3D transvaginal ultrasound （TVUS） with a mechanical 5 to 9 MHz 3D endovaginal probe. A routine pelvic examination was performed by 2D endovaginal ultrasound. A hydrosalpinx was suspected when a sausage- like or echo-free mass was seen around the ovary. 3D volumes of the mass were acquired and were displayed in muhiplanar and in-version imaging rendered modes. Results Identification of hydrosalpinx was from physical vaginal exam by gynecologists in 29/ 51 and by transvaginal color Doppler 2D ultrasound in 39/51. Eight cases were misdiagnosed as ovarian cysts, 2 cases were misdi- agnosed as parovarian cysts and 2 cases were missed entirely on transvaginal ultrasound. The diagnostic accuracy of 2D transvaginal ultrasound was 76%. Transvaginal 3D ultrasound suggested that 48 cases were hydrosalpinx, 2 were misdiagnosed as ovarian cysts and 1 case was misdiagnosed as parovarian cyst. 3D inversion rendering displays offered a more complete stereoscopic display, showed tortuous patterns and trends, and internal structure of the hydrosalpinx and the relationship to the surrounding organs. The diagnostic accuracy for hydrosalpinx was 94% for 3D ultrasound. On ultrasound, concurrent fibroids （5 cases） , adenomyosis （7 cases）, and ovarian cyst （11 cases） were demonstrated. Pelvic fluid was seen in all 51 cases. Hydrosalpinx at laporascopy was bilateral in 13 and unilateral in 35. Conclusion 3D multiplanar and inversion rendering displays offer a more complete assessment of the hydrosalpinx compared to 2D imaging, including stereoscopic display, tortuous shape, and internal structure as well as the relationship

关 键 词：输卵管积水 阴道三维超声 反转成像 

分 类 号：R711.76[医药卫生—妇产科学] R445.1[医药卫生—临床医学]