摘要
目的总结先天性子宫畸形经阴道三维超声自由解剖(Omni View)成像图像特征。方法对2012年9月至2013年7月在重庆市渝北区中医院就诊二维超声显示子宫畸形的36例患者行经阴道三维超声扫查,利用Omni View成像获取子宫冠状切面声像图,观察子宫外形,宫腔形态,宫颈管形态,并对子宫底部凹陷深度进行测量,与子宫输卵管碘油造影、宫腔镜、宫腔镜联合腹腔镜手术或磁共振检查结果对照,总结经阴道三维超声Omni View成像图像特征及应用价值。结果 36例患者经阴道三维超声检查诊断为不完全纵隔子宫16例,完全纵隔子宫5例,弓形子宫5例,双角子宫4例,双子宫4例,单角子宫2例。与临床手术或磁共振诊断均符合(36/36)。36例患者子宫畸形Omni View成像图像特征:(1)纵隔子宫21例,子宫冠状切面声像图示12例宫底肌层稍向外凸,9例子宫底肌层轻微凹陷,凹陷深度均≤1.0 cm,平均深度(0.5±0.3)cm;子宫内膜中央均见低回声分隔将子宫内膜分为左右对称的两部分,分隔从子宫底部向宫颈方向延伸;其中不完全纵隔子宫16例,分隔未达宫颈内口,内膜呈"Y"字形,完全纵隔子宫5例,分隔达宫颈内口,内膜呈"V"字形。(2)弓形子宫5例,子宫冠状切面声像图示2例宫底肌层平坦,2例宫底肌层稍向外凸,1例子宫底内膜轻微凹陷,凹陷深度约0.4 cm;5例子宫底中央部内膜均呈弧形凹陷,内膜凹陷深度均≤1.0 cm,平均深度(0.7±0.2)cm。(3)双角子宫4例,子宫冠状切面声像图示子宫底部横径均明显增宽,宫底外缘明显凹陷呈分开的两个子宫角,子宫外形呈"Y"字形,凹陷深度均>1.0 cm(分别为1.7 cm和2.3 cm,2.6 cm和2.8 cm);两侧子宫角内均可见子宫内膜回声,双侧分开的子宫内膜汇合于子宫中下段至宫颈内口处,子宫内膜亦呈"Y"字形。(4)双子宫4例,子宫冠状切面声像图均显示2个完整的子宫体和子宫颈,有各自完整的子宫壁和子宫内膜。(5)单角子宫2例,子宫轮廓偏小,呈梭形,宫底横径较小,1例子宫内膜呈"香蕉"形,1例内膜呈管状。结论经阴道三维超声Omni View成像可在二维超声基础上获取满意的子宫冠状切面超声图像而清晰显示子宫外形和宫腔形态,并可准确测量子宫底凹陷深度,可为先天性子宫畸形分型诊断和鉴别诊断提供更多诊断信息。
Objective To summarize the sonographic features and the diagnostic value of transvaginal three dimensional Omni View sonography for congenital uterine malformation. Methods Thirty-six patients who were suspected as uterus septus on transvaginal two-dimensionalultrasound(2D US) were examined by transvaginal three dimensional ultrasound(3D US) of Omni View. The coronal plane images were acquired. The fundus,cavity and cervix of the uterus were analyzed. The depths of fundal cleft were measured.In comparison with the test results of hysterosalpingography(HSG), hysteroscopy, hysteroscopy combined with laparoscope or magnetic resonance imaging(MRI), the sonographic features and the diagnostic value of transvaginal three dimensional Omni View sonography were summarized. Results Among the 36 cases underwent transvaginal three-dimensional ultrasound(3D US), 16 cases were diagnosed as incomplete septate uterus, 5 cases as complete septate uterus, 5 cases as arcuate uterus, 4 cases as bicornuate uterus, 4 cases as gemini and 2 cases as unicornuate uterus. The results of all 36 cases were confirmed by surgery or magnetic resonance imaging(MRI). The sonographic features of transvaginal three dimensional Omni View sonography:(1) Twenty-one septate uterus had convexes(in 12 cases) or minimally depressed fundus(in 9 cases, depth of cleft ≤ 1.0 cm) and had Y-shaped(16 incomplete septate uterus without septum extending into cervix) or V-shaped cavity(5 complete septate uterus with septum extending into cervix).(2) Five arcuate uterus had an obtuse angle at the central point of septum.(3) Four bicornuate uterus had fundal depression more than 1.0 cm and were divided into two cornuas.(4) Four gemini had two complete uterus and cervix.(5) Two uterus unicornis had single endometrial and smaller than normal. Conclusions Transvaginal 3D Omni View sonopgraphy of uterine may display a good coronal plane, on which the relationship of the cavity and the fundus, the depth of fundal cleft and the angle at the central point of the septum can be well depicted and measured. It is a practical, reliable and noninvasive method, and superior to 2D US in the diagnostic classification of complex uterus malformation.
出处
《中华医学超声杂志（电子版）》
CSCD
2015年第2期122-127,共6页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
三维
诊断成像
子宫
先天畸形
Ultrasonography,three-dimensional
Diagnostic imaging
Uterus,congenital abnormalities
