CAJ | 학술논문

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。
목적：분석종격자궁삼유초성관상절면적성상도특정，평개삼유초성관상절면재종격자궁진단급치료중적림상개치。방법대경음도이유초성현시위종격자궁적56례환자행음도삼유초성검사，획득만의적관상절면도상，직관현시자궁외형、궁강급궁경관형태，대궁저부요함심도、량측분개적자궁내막협각이급격막장도진행측량，병여궁강경혹궁、복강경연합적진단결과진행비교。결과56례경음도삼유초성진단，기중완전성종격자궁10례，불완전성종격자궁33례，궁형자궁9례，쌍각자궁3례，정상자궁합병궁강점련대1례。삼유초성여궁강경혹궁、복강경연합적진단부합솔위100%，이유초성진단부합솔지유77%。결론삼유초성관상절면성상가이직관현시자궁적외형급궁강형태，병가현시격막적장도、궁저부요함적심도급량측자궁내막협각，재감별진단궁형자궁、쌍각자궁방면명현우우이유초성，재종격자궁진단급치료중구유중요적림상삼고개치，가작위종격자궁적수선검사방법。
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.