经阴道超声和HSG诊断子宫畸形的对比分析

目的探讨经阴道超声和子宫输卵管造影(HSG)在诊断子宫畸形中的价值。方法收集2009年4月至2010年12月在复旦大学附属妇产科医院因不孕就诊的患者共61例,均进行经阴道超声检查和子宫输卵管造影术(HSG)检查,所有患者进一步做宫腔镜或宫腹腔镜联合检查确诊,从而对比两种检查方法的诊断准确率及误诊率。结果经阴道超声和HSG对单角子宫的误诊率均为7.0%,符合率均为95.1%;经阴道超声对双子宫的漏诊率为0%,符合率为100.0%,而HSG对双子宫的漏诊率为10.0%,符合率为96.7%;经阴道超声对纵隔子宫的漏诊率0%,符合率为100.0%,而HSG对纵隔子宫的漏诊率为15.0%,符合率为91.8%。结论经阴道超声检查对纵隔子宫、双子宫等子宫畸形的诊断符合率高于HSG,是准确、无创的检查方法。对于复杂的、不典型的子宫畸形,上述两种方法诊断还有一定困难,还需要结合宫腔镜或宫腹腔镜联合明确诊断。

Transvaginal ultrasonography VS HSG in diagnosis of uterine anomalies

Objective： To probe the diagnosis and application of transvaginal ultrasound and hysterosalpingogram （HSG） in diagnosis of uterine anomalies. Methods： Patients in infertility clinic were scanned by transvaginal sonography and hysterosalpingogram. Hysteroscopy were performed patients with uterine anomalies and with infertility caused by tubal factors, and examined and cured by transvaginal sonography and hysterosalpingogram, and comparative analysis. Results ： The misdiagnosis rate of uterus unicornis on ultrasonography and on HSG were 7% , the compliance rate were 95.1%. The misdiagnosis rate of uterus didelphys on uhrasonography was 0% , and the compliance rate was 100%. Those on HSG were 10% and 96. 7%. The misdiagnosis rate of uterus septus on ultrasonography was 0%, and the compliance rate was 96. 7%. Those on HSG were 15% and 91.8%. Conclusion： Transvaginal ultrasound was considered a more useful method in diagnosing uterine anomalies than HSG. For complex, atypical uterine malformations, the diagnosis of these two methods have some difficulties, but also combined with hysteroscopy or laparoscopy to confirm the diagnosis.