多普勒超声诊断输卵管炎的临床研究

目的探讨阴道彩色多普勒超声检查不同类型输卵管炎的声像图表现及临床价值.方法收集56例输卵管炎患者的声像图表现及临床治疗.结果 （1）单纯型17例,附件区见管状不均质回声,CDFI显示内部血流较丰富.经抗生素治疗2～3周后管状不均质回声明显缩小或消失;（2）积液型39例,附件区见扭曲管状、腊肠状或盲袋状囊性包块,壁上见星点状彩色血流.其中21例包块较小者经抗生素治疗2～3周后包块缩小不明显.39例经腹或腹腔镜手术证实为输卵管积水28例,合并卵巢积水6例,输卵管、卵巢积脓、合并盆腔脓肿11例.误诊2例,漏诊1例.超声诊断符合率94.6%（36/39）.结论 TVS-CDFI对输卵管炎有较高的诊断价值,区分类型对临床选择治疗方法有重要的参考意义.

Transvaginal Color Doppler Ultrasound Sonographic Appearance and Its Clinical Significance for Salpingitis

Objective To investigate the transvaginal scaning,color Doppler flow image（TVS-CDFI）sonographic appearance and its clinical significance for salpingitis with different types.Methods 56 patients with salpingitis confirmed by surgery,diagnostic laparoscopy,and diagnostic treatment were selected in this study.The sonographic appearance and clinical situations were analyzed respectively.Results The sonographic appearance of salpingitis had two types：（1）simple type：17 cases,tubular heterogeneous echo was found in the accessory area,short axis 1.2～2.8 cm,long axis 5.3～11.5 cm,CDFI showed rich blood flow.The diagnostic treatment significantly reduced or eliminated tubular heterogeneous echo.（2）fluid type： 39 cases,twisted tubular,sausage-shaped cystic mass or a blind pocket was found in accessory area,short axis 1.3～5.3 cm,length Axis 2.8～10.8 cm,CDFI showed satellite spot-like color flow on the wall.Among the 28 cases of hydrosalpinx confirmed by surgery or laparoscopy,there were 6 cases of hydrosalpinx complicated with hydrovarium,11 cases of fallopian tube and ovary empyema complicated with pelvic abscess.There were 2 cases of misdiagnosis and 1 case of missed diagnosis in cases of fluid type,the ultrasound diagnosis accordance rate was 92.3%.Conclusions TVS-CDFI has high diagnostic value for salpingitis.Distinguishing simple type or fluid type has high reference value for selecting and making clinical treatment programs.