基于三维超声以不同标准诊断纵隔子宫  

Comparison on diagnosing septate uterus with different diagnostic criteria based on 3D ultrasound

作　　者：武芳彩 胡蓉[1] WU Fangcai;HU Rong(Department of Obstetrics and Gynecology Ultrasound,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Key Laboratory of Ultrasound Medicine,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院妇产超声诊断科,新疆超声医学重点实验室,新疆乌鲁木齐830054

出　　处：《中国介入影像与治疗学》2025年第3期178-182,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的对比基于三维超声以美国生殖医学学会(ASRM)-2021、欧洲人类生殖与胚胎学会与欧洲妇科内镜学会(ESHRE/ESGE)-2016、先天性子宫畸形专家小组专家共识(CUME)-2018标准诊断纵隔子宫的价值。方法回顾性收集三维超声显示宫底内膜明显凹陷(凹陷深度≥0.5 cm)且宫底肌层浆膜面无明显凹陷或轻度凹陷(凹陷深度<1.0 cm)而疑诊纵隔子宫的164例育龄女性,其中114例既往有不良孕产史,包括不孕、流产、异位妊娠等。观察子宫三维超声表现,测量子宫内膜凹陷深度(纵隔长度)及角度、子宫宫底浆膜面凹陷深度等,分别根据ASRM-2021、ESHRE/ESGE-2016、CUME-2018标准诊断纵隔子宫并进行对比。比较以3种标准针对既往有、无不良孕产史者诊断纵隔子宫的差异,分析3种标准诊断纵隔子宫的纵隔长度及子宫内膜凹陷角度与不良孕产史的相关性。结果164例中,根据ASRM-2021标准对纵隔子宫的诊断率为43.90%(72/164),其余28.05%(46/164)为非纵隔子宫、28.05%(46/164)为无法明确诊断;以ESHRE/ESGE-2016标准对纵隔子宫的诊断率为96.95%(159/164),另3.05%(5/164)为非纵隔子宫;基于CUME-2018标准对纵隔子宫的诊断率73.78%(121/164),另26.22%(43/164)为非纵隔子宫。基于以上3种标准诊断纵隔子宫结果两两比较差异均有统计学意义(χ2=32.818~81.387,P均<0.001)。基于ASRM-2021及CUME-2018标准针对既往有不良孕产史患者的纵隔子宫诊断率均高于无不良孕产史者(P均<0.05),而以ESHRE/ESGE-2016标准诊断结果与针对无不良孕产史者差异无统计学意义(P=0.981)。分别基于ASRM-2021、ESHRE/ESGE-2016及CUME-2018标准检出72、159及121例纵隔子宫,其中分别有57、110及91例有不良孕产史;基于ESHRE/ESGE-2016及CUME-2018标准所诊断纵隔子宫的纵隔长度与不良孕产史均呈正相关,以上述标准所诊断的纵隔子宫的子宫内膜凹陷角度均与不良孕产史呈负相关(P均<0.05)。结论相比基于ASRMObjective To compare the value of diagnosing septate uterus based on 3D ultrasound using American Society for Reproductive Medicine(ASRM)-2021,European Society of Human Reproduction and Embryology and European Society of Gynecological Endoscopy(ESHRE/ESGE)-2016,Congenital Uterine Malformation by Experts(CUME)-2018 criteria.Methods A total of 164 women of childbearing age with suspected septate uterus due to obvious indentation of endometrium of fundal(indentation depth≥0.5 cm)and no obvious or mild indentation of serous membrane of fundal muscle(indentation depth<1.0 cm)revealed by 3D ultrasound were retrospectively collected.Among them,114 cases had previous adverse pregnancy events,including infertility,abortion and ectopic pregnancy,etc.Then 3D ultrasonic manifestations of uterus were observed,the depth(septate length)and angle of endometrial depression and the depth of uterine fundus serosa depression were measured.Septate uterus was diagnosed according to ASRM-2021,ESHRE/ESGE-2016 and CUME-2018 criteria,respectively,and the diagnostic results were compared.For patients with and without previous adverse pregnancy,the diagnostic results of septate uterus using 3 kinds of criteria were compared,and the correlations of septate length and the angle of endometrial depression of septate uterus diagnosed using 3 kinds of criteria and adverse pregnancy events were analyzed.Results Among 164 cases,the diagnosis rate of septate uterus according to ASRM-2021 criteria was 43.90%(72/164),the remaining 28.05%(46/164)were non-septate uterus and 28.05%(46/164)were not clearly diagnosed.According to ESHRE/ESGE-2016 criteria,the diagnosis rate of septate uterus was 96.95%(159/164),and the other 3.05%(5/164)was non-septate uterus.The diagnosis rate of septate uterus based on CUME-2018 criteria was 73.78%(121/164),and 26.22%(43/164)was non-septate uterus.There were significant differences of diagnosing results of septate uterus based on the above three criteria(χ2=32.818—81.387,all P<0.001).For patients with previous advers

关 键 词：子宫附件疾病 诊断 超声检查 

分 类 号：R711.74[医药卫生—妇产科学] R445.1[医药卫生—临床医学]