宫腔声学造影诊断剖宫产术后子宫切口憩室的价值

目的 探讨宫腔声学造影(SHG)诊断剖宫产术后子宫切口憩室的价值。方法 对剖宫产术后临床怀疑子宫切口憩室的28例患者进行宫腔声学造影检查及常规经阴道超声(TVS)检查，观察并测量憩室大小及肌层厚度，观察对比两种超声检查方法诊断切口憩室的价值。超声检查后均进行宫腔镜检查，并以宫腔镜检查结果作为金标准。结果 宫腔镜检查发现20例子宫切口憩室、宫腔声学造影检查发现20例、常规经阴道超声检查发现17例。以宫腔镜检查结果为金标准，SHG、TVS诊断子宫切口憩室的准确率分别为100%(20/20)、89.29%(17/20)。TVS测量憩室上下径(9.17±2.63) mm]、左右径(11.76±5.67) mm]及肌层厚度(3.29±1.01) mm]与SHG测量结果上下径：(12.01±4.04) mm、左右径：(12.37±6.14) mm、厚度：(2.85±1.30) mm]差异均有统计学意义(P均<0.05)，TVS与宫腔声学造影测量的憩室高度(5.62±2.13) mm vs (5.50±2.34) mm]差异无统计学意义(P>0.05)。宫腔声学造影还发现宫腔粘连带5例、子宫内膜息肉4例、黏膜下肌瘤1例。结论 宫腔声学造影诊断剖宫产术后子宫切口憩室具有一定的临床价值。

Value of sonohysterography in diagnosis post-cesarean section scar diverticulum

Objective To explore the value of sonohysterography (SHG) in diagnosis of post-cesarean scar diverticulum. Methods Totally 28 patients with post-cesarean scar diverticulum suspected clinical underwent SHG and conventional transvaginal ultrasound (TVS).The sizes of the diverticulum and the thickness of muscular layer were observed and the diagnostic value of SHG and TVS were compared. All patients underwent hysteroscopy, and the results were considered as diagnostic standard. Results Twenty diverticulums were found by hysteroscopy, 20 diverticulums by SHG and 17 diverticulums by TVS. Taking hysteroscopy as diagnostic standard, the accuracy of SHG, TVS in diagnosis of diverticulums were 100% (20/20) and 89.29% (17/20) respectively. Superoinferior diameter (9.17±2.63]mm), left-right diameter (11.76±5.67]mm) of diverticulum and thickness of muscular layer (3.29±1.01]mm) measured by TVS had statistical differences compared with those measured by SHG (superoinferior diameter:12.01±4.04]mm, left-right diameter:12.37±6.14]mm, thickness:2.85±1.30]mm, all P<0.05). The altitude of diverticulum measured by TVS and SHG had no statistial difference (5.62±2.13]mm vs 5.50±2.34]mm, P>0.05). Five patients with intra-uterine adhesions, 4 with endometrial polyps and 1 with submucosal myoma were detected by SHG. Conclusion SHG has clinical value in diagnosis of post-cesarean scar diverticulum..