阴道斜隔综合征的影像学特征及诊断价值

目的 探讨阴道斜隔综合征的影像学表现及其诊断价值.方法 回顾性分析13例阴道斜隔综合征患者的临床及影像学资料并复习相关文献.13例术前均行超声检查,其中8例行MRI检查,并行CT检查3例.分析斜隔的位置,隔后腔的大小,隔后腔与宫颈的位置关系,双侧附件及泌尿系的伴发改变.结果 超声、MRI检查均表现为双子宫、双宫颈、双阴道且一侧阴道闭锁,斜隔起于两侧宫颈之间,斜行附着于一侧阴道壁,遮蔽该侧宫颈;斜隔位于右侧4例,左侧9例;6例 Ⅰ 型隔后腔容积平均为255 mL,6例Ⅱ型隔后腔容积平均为74 mL,1例Ⅲ型隔后腔容积为56 mL;合并斜隔侧输卵积血2例,合并斜隔侧卵巢巧克力囊肿1例;伴斜隔侧肾缺如12例,伴斜隔侧肾发育不全1例.3例CT检查均表现为双子宫、双宫颈,一侧宫颈下方囊状低密度影及同侧肾缺如.结论 阴道斜隔综合征的影像学表现颇具特征性.超声、CT和MRI对准确诊断有一定价值.

Imaging features of oblique vaginal septum syndrome and its diagnostic value

Objective To investigate the imaging findings of oblique vaginal septum syndrome and its diagnostic value.Methods Clinical and radiographic data of 13 patients with oblique vaginal septum syndrome were analyzed retrospectively and relevant literatures were reviewed.All 13 patients underwent ultrasonography examination preoperatively,and 8 of them underwent MRI examination,and 3 patients underwent CT examination as well.The position of the oblique septum,the size of the cavity in the rear of oblique septum, the positional relationship between the cavity in the rear of oblique septum and the cervix,and the concomitant changes of the uterine appendages and urinary system were analyzed.Results The ultrasonography and MRI examinations all manifested as uterus didelphys,cervix duplex,double vagina and obstructed hemivagina,and oblique septum originated from the middle of cervix duplex and attached to one side of the vaginal wall,shielding the ipsilateral cervix;oblique vaginal septum was on the right side in 4 cases and on the left side in 9 cases;the average volume of the cavity in the rear of oblique septum in 6 cases of type Ⅰ was 255 mL,and the average volume in 6 cases of type Ⅱ was 74 mL,and the volume in 1 case of type Ⅲ was 56 mL;2 cases were combined with ipsilateral hematosalpinx and 1 case was combined with a chocolate cyst of ipsilateral ovary;12 cases were accompanied with ipsilateral renal agenesis and 1 case was accompanied with ipsilateral renal hypoplasia.CT examinations of 3 cases all presented as uterus didelphys,a cystic hypodensity lesion under unilateral cervix and ipsilateral renal agenesis.Conclusion Imaging findings of oblique vaginal septum syndrome are quite characteristic. Ultrasonography,CT and MRI examinations have certain value for accurate diagnosis of the disease.