先天性阴道斜隔综合征临床特征及影像学诊断价值的初步研究  

Congenital vaginal oblique septum syndrome:clinical features and diagnostic value of imaging examinations

作　　者：孝梦甦 戴晴 齐振红 Xiao Mengsu;Dai Qing;Qi Zhenhong(Department of Ultrasound Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College Union Translational Medicine Center,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院超声医学科协和转化医学中心,100730

出　　处：《中华医学超声杂志（电子版）》2022年第10期1058-1064,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金项目(82171967)。

摘　　要：目的探讨先天性阴道斜隔综合征(OVSS)临床特征及影像学诊断价值。方法回顾性分析2017年1月至2022年4月在北京协和医院手术的102例OVSS患者的临床及影像资料,以手术及病理结果为诊断标准,总结分析不同类型OVSS的临床特征及超声和MRI诊断结果。结果102例OVSS患者中,Ⅰ型30例,Ⅱ型43例,Ⅲ型15例,Ⅳ型14例。Ⅰ型的发病年龄及初潮至发病时间间隔均显著小于其他3种类型(P均<0.05)。痛经及腹痛在Ⅰ型(83.33%)及Ⅳ型(100.00%)的发生率明显高于Ⅱ型(44.19%)及Ⅲ型(40.00%),差异均有统计学意义(P均<0.05)。月经淋漓不尽在Ⅲ型(46.67%)的发生率明显高于Ⅰ型(10.00%)及Ⅳ型(0),差异均有统计学意义(P均<0.05)。阴道脓性分泌物在Ⅱ型(25.58%)的发生率明显高于Ⅰ型(0),差异有统计学意义(P<0.05)。右侧阴道斜隔56例(56/102,54.90%),均合并右肾缺如(54.90%);左侧阴道斜隔46例(46/102,45.1%),伴有左肾缺如43例(42.16%),左肾发育不良1例(0.98%)。102例患者均进行了超声检查,超声正确诊断双子宫双宫颈92例,正确诊断完全型纵隔子宫7例,超声诊断与手术符合率为97.06%(99/102)。82例进行了MRI检查,MRI正确诊断双子宫72例,正确诊断完全型纵隔子宫5例,MRI诊断与手术符合率为93.90%(77/82)。所有102例均进行了阴道斜隔切除术治疗,其中55.88%(57/102)进行了腹腔镜探查联合阴道斜隔切除术,19.61%(20/102)切除患侧子宫。Ⅳ型卵巢子宫内膜异位囊肿的发生率显著高于Ⅰ型及Ⅱ型(P均<0.05)。Ⅳ型采用的腹腔镜探查联合阴道斜隔切除术及患侧子宫切除术明显多于其他3型(P均<0.05)。结论不同分型的OVSS临床特征有所不同,超声与MRI均可较好地早期诊断OVSS及其并发症,为手术方案的选择提供重要信息。Objective To explore the clinical features of congenital vaginal oblique septum syndrome(OVSS)and assess the value of imaging examinations in the diagnosis of this disease.Methods The clinical and imaging data of 102 patients with OVSS who underwent surgery at Peking Union Medical College Hospital from January 2017 to April 2022 were retrospectively analyzed.The clinical characteristics of OVSS were summarized,and the diagnostic value of ultrasonography and magnetic resonance imaging(MRI)for different types of OVSS was assessed by using surgical and pathological results as the diagnostic criteria.Results Of 102 cases of OVSS included,30 were typeⅠ,43 were typeⅡ,15 were typeⅢ,and 14 were typeⅣ.The onset age and time interval from menarche to onset of typeⅠwere significantly lower than those of the other three types(P<0.05 for all).The incidence of dysmenorrhea and abdominal pain in typeⅠ(83.33%)and typeⅣ(100%)was significantly higher than that in typeⅡ(44.19%)and typeⅢ(40.00%)(P<0.05 for all).The incidence of prolonged menstrual duration in typeⅢ(46.67%)was significantly higher than that in typeⅠ(10.00%)and typeⅣ(0)(P<0.05 for both).The incidence of purulent vaginal secretions in typeⅡ(25.58%)was significantly higher than that in typeⅠ(0)(P<0.05).There were 56 cases(56/102,54.90%)of right vaginal oblique septum,and all cases were complicated with absence of the right kidney(54.90%).There were 46 cases(46/102,45.1%)of left vaginal oblique septum;43 cases(42.16%)had absence of the left kidney,and 1 case(0.98%)had left renal dysplasia.All of the 102 patients underwent ultrasound examination;92 cases were correctly diagnosed as having uterus duplex and double cervix,and 7 were correctly diagnosed as having complete septate uterus.The coincidence rate between ultrasound diagnosis and operation was 97.06%(99/102).Eighty-two patients underwent MRI examination,of which 72 were correctly diagnosed with uterus duplex,and 5 were correctly diagnosed with complete septate uterus.The coincidence rate

关 键 词：子宫 超声检查 阴道斜隔综合征 磁共振成像 

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