经阴道三维超声对宫腔病变的鉴别诊断

目的 评价经阴道三维超声在宫腔病变中的诊断价值。方法 对74例经阴道三维超声诊断并经宫腔镜及手术病理证实的宫腔病变的超声图像特征进行了回顾性分析，子宫黏膜下肌瘤38例，内膜息肉21例，子宫内膜增生过长10例，子宫内膜癌5例。结果 常见几种宫腔病变的声像图特征如下：1．子宫黏膜下肌瘤：多呈圆形均匀低回声区，内膜线中断或断续状，并可找到蒂所在处；2．子宫内膜息肉：呈椭圆形中等或较强回声，病变大多呈水滴状，基底窄；3．子宫内膜增生过长：内膜最厚达24mm，分泌期呈三线征；4．子宫内膜癌：病灶形态不规则，多呈较强回声，与肌层分界不清。结论 经阴道三维超声宫腔和内膜厚度及形态显示清晰，形象，立体感强，有利于了解病灶大小和病灶空间位置，大大提高了诊断准确率。

Differential Diagnosis of Three-dimensional Transvaginal Sonography in Uterine Cavity Diseases

Objective To evaluate the clinical value of three-dimensional transvaginal ultrasound(3-DTVS) in diagnosing uterine cavity diseases.Methods A total of 74 cases with uterine cavity diseases were diagnosed on 3-D US proved by hysteroscopy and pathology.There were submucous hysteromyoma in 38 cases,endometrial polyps in 21,endometrial proliferation in 10 and endometrial carcinoma in 5 cases.Results The characteristics on sonograms were as follows:1.Submucous hysteromyoma presented circular,homogeneous low-echoes with interrupted endometrium and pedicles.2.Endometrial polyps showed medium or strong echoes in oval shape like drops with narrow base.3.Endometrial hyperplasia revealed a 24 mm of endometrial thickness with strong echoes and with three thread-like sign in secretary stage.4.Endometrial carcinoma showed strong echoes.irregular in shape and unclear boundaries with muscular layers.Conclusions 3-DTVS can demonstrate the intrauterine diseases clearly with stereo-type visualization useful for detecting the sizes and locations of the lesions,so as to improve the diagnostic accuracy rates.