腔内三维超声诊断阴道斜隔综合征

目的 探讨腔内三维超声诊断先天性阴道斜隔综合征(OVSS)的临床价值。 方法 收集经手术证实的154例双子宫及完全性纵隔子宫患者的临床资料,回顾性分析其中15例OVSS的临床表现及声像图特征。 结果 15例阴道斜隔综合征中,8例首诊行二维超声检查漏误诊,后复诊时经腔内三维超声检查获得正确诊断,余7例首诊经腔内三维超声检查即获得正确诊断。OVSS声像图表现为双子宫或完全纵隔子宫、双宫颈、斜隔侧隔后阴道腔积液,14例伴斜隔侧肾脏缺如。 结论 腔内三维超声有助于提高OVSS的诊断准确率。     

三维超声在早孕期残角子宫妊娠诊断中的应用价值

目的探讨三维超声在早孕期残角子宫妊娠诊断中的应用价值,以期提高残角子宫妊娠的诊断准确性.方法对我院收治的5例早孕期残角子宫妊娠患者的临床表现、二维及三维超声声像图特征及手术病理诊断结果进行总结分析.结果5例患者均无阴道出血表现,其中1例轻度腹痛,经腹部超声检查提示为双子宫,右侧子宫内妊娠;4例患者无明显腹痛,其中1例经阴道超声检查提示为异位妊娠,子宫外包块;其余3例经腹部及经阴道超声检查结合三维超声子宫冠状切面成像检查显示子宫均呈“单角状”,子宫外包块提示诊断为残角子宫妊娠.5例患者均行残角子宫及患侧输卵管切除,手术病理检查证实均为残角子宫妊娠.结论经腹部及经阴道超声结合三维超声检查可提高早孕期残角子宫妊娠诊断的准确性,从而预防残角子宫妊娠破裂及出血等不良后果的发生.     

三维超声在早孕期残角子宫妊娠诊断中的价值

目的探讨三维超声在早孕期残角子宫妊娠诊断中的价值。方法回顾性分析12例早孕期残角子宫妊娠患者的超声声像学资料。结果 12例患者9例行二维联合三维超声检查,其中8例诊断为残角子宫妊娠,1例诊断为单角子宫妊娠合并残角子宫妊娠;余3例行二维超声检查,误诊为输卵管妊娠。残角子宫妊娠典型超声声像图特征:与宫颈相连的一侧子宫呈"单角状",该宫腔内无妊娠囊;于单角子宫旁中下段可见一包块,包块内可见妊娠囊,包块周边可见肌样组织,包块与宫颈不相延续。结论二维联合三维超声检查可提高早孕期残角子宫妊娠诊断的准确性。     

三维断层超声显像诊断瘢痕子宫妊娠

目的 探讨三维断层超声显像(TUI)技术诊断瘢痕子宫妊娠(CSP)的价值。方法 对46例二维超声早孕期检查疑似瘢痕子宫妊娠患者分别进行TUI及MR检查,将诊断结果与手术病理结果对比,评价二者诊断一致性。并采用TUI技术对CSP进行分型,并与手术病理结果进行对比。结果 TUI与MRI技术对CSP的诊断一致性良好(Kappa=0.75),TUI技术对CSP分型结果同手术结果相一致。结论 三维TUI技术对CSP有较高的诊断价值,可为临床提供合理可靠的信息,且可实时动态观察病变部位,检查时间短、价格低廉,值得临床推广应用。     

腔内二维联合三维超声在诊断残角子宫妊娠中的价值

目的总结腔内二维联合三维超声在诊断残角子宫妊娠中的价值。方法对我科室诊断及漏诊的残角子宫妊娠进行分析,总结漏诊原因以及腔内二维联合三维超声的应用价值。结果应用二维联合三维超声共诊断残角子宫妊娠8例,超声表现为未妊娠侧三维超声均显示为单角子宫,并于其旁可见厚壁的孕囊及(或)胎儿但不与宫颈相通,8例诊断结果均与手术所见符合;漏诊2例,均为经腹部检查,未应用腔内超声检查。结论腔内三维超声能够显示单宫角的宫腔形态,丰富诊断信息,联合二维超声可以提高残角子宫妊娠的诊断率,具有重要的临床应用价值。     

MRI诊断罕见部位异位妊娠

目的 观察MRI对诊断罕见部位异位妊娠（EP）的价值。方法 回顾性分析14例经临床或病理诊断的EP患者,观察妊娠物位置、大小、形态及MRI信号特征等,并与手术病理结果对照。结果 14例中,2例右侧残角子宫妊娠,5例宫角妊娠,3例输卵管间质部妊娠,2例宫颈妊娠,1例腹膜后直肠侧间隙妊娠,1例子宫肌壁间妊娠。MRI定位诊断EP结果与手术病理所见相符。结论 MRI可用于定位诊断罕见部位EP。     

三维超声诊断单角子宫和残角子宫的价值

单角子宫和残角子宫是反复流产与不孕的重要原因．残角子宫妊娠可以发生扭转或破裂，准确诊断可预防不良后果的发生。但是，目前单角子宫和残角子宫的漏诊和误诊仍不少。三维超声以其能显示子宫冠状面的优势，已广泛应用于节育环异位、纵隔子宫等诊断，但对单角子宫和残角子宫的诊断报道甚少。为研究三维超声对单角子宫和残角子宫的诊断价值，笔者对25例二维超声检查疑单角子宫、残角子宫，或来源、性质无法确定的宫旁包块患者行三维超声检查，并对检查结果进行分析总结。     

实时三维超声鉴别诊断阴道后壁膨出病变

目的 探讨经会阴实时三维超声鉴别诊断阴道后壁膨出病变的价值。方法 对91例临床确诊为阴道后壁膨出的患者应用经会阴实时三维超声进行检查,评价图像质量,并分析其声像图特点。结果 91例患者均能配合并完成检查。图像质量评分均为3分。超声诊断直肠膨出38例,会阴体过度运动48例,肠疝5例。直肠膨出及会阴体过度运动均表现为直肠壶腹部不同程度下移至参考线以下,但只有前者膨出物突向阴道内;肠疝表现为疝出物位于直肠壶腹部与阴道间。结论 经会阴实时三维超声可用于阴道后壁膨出病变的鉴别诊断,可为临床治疗提供更多有价值的信息。     

经阴道三维超声诊断子宫发育异常的准确性及可重复性

目的 评价经阴道三维超声(TV3DUS)诊断子宫发育异常的价值及测量宫腔的可重复性。方法 随机选择接受TV3DUS检查的30例子宫正常及49例子宫发育异常的患者进行分析,测量其中39例发育异常子宫的宫腔底部宽度、宫底内膜面向宫腔凸起高度或纵隔长度、宫腔长度。由2名医师在双盲情况下分别独立完成图像的分析、测量和诊断,对诊断结果和测量数据进行一致性检验。结果 2名医师诊断子宫发育异常具有高度一致性(Kappa=0.932,P<0.01)。对39例发育异常子宫宫腔径线的测量结果显示,观察者内及观察者间均有高度一致性,组内相关系数均高于0.8。结论 TV3DUS可准确诊断子宫发育异常,其测量宫腔径线的可重复性良好。     

三维超声生理盐水宫腔声学造影与宫腔镜检查对子宫黏膜下肌瘤分型对比

目的 评估三维超声生理盐水宫腔声学造影(3D-SIS)对子宫黏膜下肌瘤术前分型的临床价值。 方法 选择因不规则阴道出血并经阴道超声检查(TVS)诊断为子宫黏膜下肌瘤的患者62例,用3D-SIS与宫腔镜(HS)检查按照欧洲宫腔镜学会对黏膜下肌瘤的分型标准,分别对子宫黏膜下肌瘤进行分型并与术后分型结果比较。 结果 62例患者共检出子宫黏膜下肌瘤73个,均经手术证实,3D-SIS及HS检查对子宫黏膜下肌瘤分型的一致性分别为:0型100%(13/13);Ⅰ型92.31%(24/26);Ⅱ型82.35%(28/34),总一致性为89.04%(65/73)。 结论 通过术前对子宫黏膜下肌瘤的分型,3D-SIS对选择合适的手术方式具有重要的临床价值。     

Diagnosis and laparoscopic management of a rudimentary horn pregnancy: Role of three‐dimensional ultrasound

Rudimentary horn pregnancy occurs in 1 in 76,000–150,000 pregnancies and causes uterine rupture in about 80% of cases. The use of three‐dimensional transvaginal ultrasound seems to be useful for its early detection. We present a case of an 8‐week pregnancy in a rudimentary horn, managed by laparoscopic excision. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45 :112–115, 2017;     

子宫角妊娠的超声特征与误诊分析

目的总结子宫角妊娠超声声像图特征和鉴别诊断要点.方法 与手术病理检查结果对比,对常规腹部超声及经阴道超声诊断的93例子宫角妊娠患者的术前超声声像图表现及超声分型特征进行总结.结果 与手术病理诊断结果对比显示,术前超声诊断子宫角妊娠与手术病理诊断符合66例(82.5%,66/80),其中妊娠囊型子宫角妊娠55例,混合包块型子宫角妊娠11例;误诊为输卵管间质部妊娠11例、残角子宫妊娠2例、绒癌1例;术前超声误诊率为17.5%(14/80);术前超声表现为附件区异位妊娠包块13例,术中显示为子宫角妊娠包块破裂,超声未定位和分型诊断.子宫角妊娠的超声特征为妊娠囊位于膨隆的一侧子宫角,周边有薄层肌壁包绕,子宫角妊娠包块与宫内膜相连.14例子宫角妊娠误诊原因:(1)超声显示子宫角包块与子宫内膜不连接、包块不为子宫肌层包绕,误诊为输卵管间质部妊娠.(2)子宫角外侧肌层厚,误诊为残角子宫妊娠.(3)子宫角包块血流丰富,肌层菲薄,误诊为绒癌.结论 经腹部联合经阴道超声能对子宫角妊娠病变做出准确诊断,依据超声诊断要点综合评估有助于子宫角妊娠的鉴别诊断.     

Avoiding the fatal misdiagnosis of pregnancy in a noncommunicating rudimentary horn using 3D transvaginal ultrasound

Rudimentary horn pregnancies are an increasingly recognized complication of Mullerian duct anomalies. They can lead to uterine rupture with severe maternal morbidity and mortality. We present the case of a 28-year-old woman with a prior surgical diagnosis of bicornuate uterus who was diagnosed with a 7-week pregnancy in the left horn of a bicornuate uterus by 2D ultrasound. Further investigation with 3D ultrasound revealed that the pregnancy was within a noncommunicating rudimentary horn of a unicornuate uterus. These findings were confirmed at laparotomy. This case illustrates the importance and benefits of utilizing 3D ultrasound in diagnosing suspected Mullerian anomalies.     

Ultrasound Features of Rudimentary Horn Ectopic Pregnancies

Rudimentary horn ectopic pregnancies are uncommonly encountered in women with müllerian duct anomalies. The clinical presentation of this entity is nonspecific, giving ultrasound a critical role in making the diagnosis. Timely diagnosis and management of rudimentary horn ectopic pregnancies are pivotal in reducing the high rates of uterine rupture and maternal mortality historically associated with this condition.     

Diagnosis and laparoscopic excision of accessory cavitated uterine mass in a young woman: A case report

BACKGROUNDAccessory and cavitated uterine mass (ACUM) is an uncommon form of connate Müllerian anomaly seen in young and nulliparous women, which presents as chronic periodic pelvic pain and severe dysmenorrhea. The entity is often underdiagnosed due to a broad differential diagnosis, including rudimentary uterine horn, true cavitated adenomyosis and degenerating fibroids.CASE SUMMARYA 22-year-old woman who presented with severe dysmenorrhea and was initially misdiagnosed with cystic adenomyosis. Gynecological examination and ultrasonography were performed. The patient underwent laparoscopic excision of the mass and histopathological examination confirmed the diagnosis. Postoperatively, the patient did well, with no further dysmenorrhea.CONCLUSIONACUM is difficult to diagnose. A correct diagnosis can be made only after excision and histopathological evaluation. Surgical excision is necessary and can be carried out by laparoscopy.     

Rudimentary horn pregnancy: first-trimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging.

OBJECTIVE: Two cases of rudimentary horn pregnancy diagnosed in the first trimester by sonography and confirmed by magnetic resonance imaging (MRI) are reported. We suggest criteria for early, prerupture sonographic diagnosis of this rare condition. METHODS: We report a case in which pregnancy in a rudimentary horn was suspected on routine sonographic examination. In the second case, sonographic examination at 11 weeks' gestation revealed a right unicornuate uterus and a noncommunicating left rudimentary horn containing a gestational sac. In both cases, MRI clearly confirmed the sonographic diagnosis, showing an empty cavity of the uterine body and a pregnant uterine horn without an endometrial communication to the uterine body. RESULTS: Both patients underwent surgery, and the pregnant rudimentary horns were resected with no complications. CONCLUSIONS: We suggest the following criteria for sonographic diagnosis of rudimentary horn pregnancy: (1) a pseudopattern of a asymmetrical bicornuate uterus, (2) absent visual continuity tissue surrounding the gestational sac and the uterine cervix, and (3) the presence of myometrial tissue surrounding the gestational sac. Typical hypervascularization of placenta accreta may support the diagnosis. Additionally, MRI can be used to confirm the diagnosis before an invasive procedure is undertaken.     

残角子宫妊娠二例超声诊断分析及文献复习

目的提高残角子宫妊娠的诊断率,避免误诊和漏诊。方法分析2例残角子宫妊娠超声声像特征,复习相关文献。结果1例确诊,1例误诊,两例手术和病理结果均为残角子宫妊娠。结论结合病史、临床表现、高分辨力超声仪检查及一定的诊断思维有助于提高残角子宫妊娠的诊断率。     

单角子宫的超声诊断

目的 探讨二维超声诊断单角子宫的价值.方法 采用Siemens Sequoia 512和Antares超声诊断仪对5例单角子宫图像的观察、分析.结果 单角子宫有特异的宫腔形态.结论 二维超声对单角子宫具有诊断价值.     

经腹部超声及经阴道超声诊断宫角妊娠的效果差异分析

目的:研究经腹部超声(TAS)与经阴道超声(TVS)对于宫角妊娠患者的作用与效果。方法:抽选我院接受并治疗的66例疑似是宫角妊娠病例,抽选时间最开始由2017年8月直到2019年8月,对所有患者都施予TAS、TVS、手术检查,把手术检查而得的结果当作"金标准",观察比较其结果。结果:在检测后,TVS诊断的总准确率、对宫角妊娠诊断的总准确率对比TAS更高,具有十分显著性的差异(P<0.05)。结论:对于宫角妊娠患者而言,TVS对比TAS能够得到更为良好的诊断效果,建议临床推崇使用。