阴道斜隔综合征的超声诊断与临床分析  

Ultrasound diagnosis and clinical analysis of obstructed hemivagina and ipsilateral renal anomaly syndrome

作　　者：包艳娟 杨小红[1] 张涛[1] 赵胜[1] 张莉[1] Bao Yanjuan;Yang Xiaohong;Zhang Tao;Zhao Sheng;Zhang Li(Department of Ultrasonography,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,China)

机构地区：[1]湖北省妇幼保健院超声诊断科,武汉430070

出　　处：《中华医学超声杂志（电子版）》2024年第9期859-864,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨阴道斜隔综合征的超声声像图特点与临床特征。方法2013年1月至2022年6月在湖北省妇幼保健院由超声诊断并经手术、病理证实的阴道斜隔综合征患者32例,回顾性分析其临床表现,总结超声声像图资料,并与手术、病理结果对照。结果斜隔发生于左侧者14例,右侧18例。手术方式:22例行单纯阴道斜隔切除术。10例行宫腔镜及腹腔镜联合斜隔切除术,其中因宫颈闭锁或发育不良行患侧子宫切除术4例,因肾盆腔异位并发育不良、输尿管异位开口行患侧肾和输尿管切除术2例。超声声像图与手术、病理综合分析:(1)生殖系统:子宫畸形为双子宫22例,完全纵隔子宫7例,双角子宫3例;并发斜隔侧宫颈闭锁2例,宫颈发育不良8例;并发隔后腔积液30例,宫腔积液21例,输卵管积血17例,输卵管积脓2例,卵巢巧克力样囊肿5例,盆腔粘连10例。(2)泌尿系统:32例均合并泌尿系统发育异常,其中肾缺如29例,肾囊性发育不良1例,肾盆腔异位并发育不良、输尿管异位开口2例。分型:Ⅰ型无孔斜隔型14例,超声诊断准确;Ⅱ型有孔斜隔型9例,超声显示阴道斜隔瘘口1例;Ⅲ型无孔斜隔合并子宫颈瘘管型7例,超声显示宫颈瘘管2例;Ⅳ型子宫颈闭锁型2例,超声显示双子宫、双宫颈畸形1例。超声能准确诊断子宫畸形、阴道积液、宫腔积液、盆腔内病灶及肾缺如、囊性发育不良、肾盆腔异位等,部分阴道斜隔瘘口及宫颈瘘管可显示,但超声分型仍然困难。结论超声检查为诊断阴道斜隔综合征首选且可靠的方法。Objective To investigate the clinical features of obstructed hemivagina and ipsilateral renal anomaly(OHVIRA)syndrome and analyze the value of ultrasonography in the diagnosis of this condition.Methods From January 2013 to June 2022,32 cases of OHVIRA syndrome diagnosed and surgically treated at Maternal and Child Health Hospital of Hubei Province were retrospectively analyzed.Results Oblique septum occurred on the left side in 14 cases and on the right side in 18.Twenty-two cases underwent oblique vaginal septum resection,and ten underwent combined hysteroscopic and laparoscopic oblique septum resection.Four cases underwent unilateral hysterectomy due to cervical atresia or dysplasia,and two underwent nephroureterectomy due to pelvic renal ectopia with dysplasia and ectopic ureteral orifice.With regard to reproductive system involvement,there were 22 cases of duplex uterus,7 cases of complete septate uterus,and 3 cases of bicornuate uterus;there were 2 cases of cervical atresia and 8 cases of cervical dysplasia;there were 30 cases of hematocolpos,21 cases of hematometra,17 cases of hematosalpinx,2 cases of pyosalpinx,5 cases of hemoperitoneum,and 10 cases of pelvic adhesion.Regarding urinary system involvement,all 32 cases were complicated with abnormal development of the urinary system.One of the kidneys was absent in 29 cases,and there was one case of renal cystic dysplasia and two cases of pelvic renal ectopia and renal dysplasia with ectopic ureteral orifice.Among the 32 cases of OHVIRA syndrome,there were 14 cases of type Ⅰ,9 cases of type Ⅱ,7 cases of type Ⅲ,and 2 cases of type Ⅳ.Ultrasonography can accurately diagnose uterine malformation,hematocolpos,hematometra,hemoperitoneum,and renal dysplasia.Conclusion Ultrasonography is the preferred and reliable method for diagnosing OHVIRA syndrome.

关 键 词：超声 子宫畸形 阴道斜隔综合征 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711[医药卫生—诊断学]