标题：经阴道三维超声冠状切面在纵膈子宫诊断中的应用

      作者：万 映，南瑞霞，张建辉，关 莹
    （海南医学院附属医院超声科，海南 海口 570102）

      卷次： 2014年25卷19期

      【摘要】 目的 分析纵膈子宫三维超声冠状切面的声像图特征，评价三维超声冠状切面在纵隔子宫诊断及
治疗中的临床价值。方法 对经阴道二维超声显示为纵膈子宫的56例患者行阴道三维超声检查，获得满意的冠
状切面图像，直观显示子宫外形、宫腔及宫颈管形态，对宫底部凹陷深度、两侧分开的子宫内膜夹角以及隔膜长
度进行测量，并与宫腔镜或宫、腹腔镜联合的诊断结果进行比较。结果 56例经阴道三维超声诊断，其中完全性
纵隔子宫10例，不完全性纵隔子宫33例，弓形子宫9例，双角子宫3例，正常子宫合并宫腔粘连带1例。三维超声
与宫腔镜或宫、腹腔镜联合的诊断符合率为100%，二维超声诊断符合率只有77%。结论 三维超声冠状切面成
像可以直观显示子宫的外形及宫腔形态，并可显示隔膜的长度、宫底部凹陷的深度及两侧子宫内膜夹角，在鉴别
诊断弓形子宫、双角子宫方面明显优于二维超声，在纵膈子宫诊断及治疗中具有重要的临床参考价值，可作为纵
膈子宫的首选检查方法。

      【关键词】 三维超声；纵隔子宫；冠状切面

      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2014）19—2856—03


Application of three-dimensional transvaginal sonography in diagnosis of mediastinal uterus.
WAN Ying, NAN
Rui-xia, ZHANG Jian-hui, GUAN Ying. Department of Ultrasound, the Affiliated Hospital of Hainan Medical University,
Haikou 570102, Hainan, CHINA

【Abstract】 Objective To explore the clinical value of three-dimensional transvaginal sonography in diagno-
sis of mediastinal uterus. Methods Fifty-six patients with mediastinal uterus diagnosed by 2D ultrasound were ex-
amined by by three-dimensional transvaginal sonography to obtain coronal section of uterus, which showed uterine
and cervical morphology. The depth of the bottom of the uterus, the angle on separate sides of endometrial, and the
length of the diaphragm was measured, and were compared with the results from hysteroscopy or laparoscopy com-
bined with hysteroscopy. Results There was 10 case of complete mediastinal uteru, 33 case of incomplete uterine
mediastinum, 9 cases of arcuate uterus, three cases of uterine horns, and one case of normal uterus combined with in-
trauterine adhesions. The diagnosis results from three dimensional ultrasound were 100% consistant with the diagno-
sis from hysteroscopy or laparoscopy combined hysteroscopy, while the accurate rate with two dimensional ultra-
sound was only 77%. Conclusion Three-dimensional ultrasound imaging can visualize coronal section of uterine
shape and morphology of the uterus, and can display the length of the diaphragm, the depth and the angle between
the bottom sides of the palace of endometrial depression. Compared with two dimensional ultrasound, it has advan-
tages in the differential diagnosis of arcuate uterus and uterine horns aspects and is worth of clinical application in
diagnosis of uterine mediastinum.

      【Key words】 Three dimensional ultrasound; Mediastinum uterine; Coronal section
·论 著·