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目的比较经阴道二维超声(2D-TVS)与三维超声(3D-TVS)诊断纵隔子宫的价值。方法选取佛山市第一人民医院2011-2016年收治的经宫腔镜确诊的纵隔子宫患者197例为研究对象,67例患者采用2D-TVS检查,130例采用3D-TVS检查,比较两组患者超声检查的敏感性、误诊率及与宫腔镜检查结果是否一致。结果 3D-TVS总检出率为(89.43%)高于2D-TVS的总检出率(64.06%),两组误诊率为(14.29%vs.66.67%),与宫腔镜的一致性为(0.74%vs.0.23%)。而对于不同纵隔子宫分型的比较表明:弓形子宫2D-TVS的灵敏度优于3D-TVS,误诊率明显低,与宫腔镜检查具有更高一致性,但是完全性纵隔子宫与不完全性纵隔子宫的检查结果则完全相反。结论 3D-TVS在诊断纵隔子宫的总检出率方面包括灵敏度、误诊率、与MRI的一致性明显优于2D-TVS,但对于美国生育协会(AFS)不同分型的诊断价值,则各有优势。鉴于目前大多数B超均可兼顾2D及3D诊断,两者联用能提高诊断的可靠性。
Objective To compare the value of transvaginal two-dimensional ultrasound (2D-TVS) and three-dimensional ultrasound (3D-TVS) in the diagnosis of mediastinal uterus. Methods 197 cases of hysteroscopic uterus diagnosed by hysteroscopy in 2011 in First People’s Hospital of Foshan City from 2011 to 2016 were selected as study objects, 67 cases were examined by 2D-TVS and 130 cases were examined by 3D-TVS. The sensitivity, misdiagnosis rate and consistency with the results of hysteroscopy. Results The total detection rate of 3D-TVS was (89.43%) higher than that of 2D-TVS (64.06%). The misdiagnosis rate of the two groups was (14.29% vs.66.67%), which was consistent with hysteroscopy (0.74% vs.0.23%). The comparison of different types of uterus in different mediastinum showed that the sensitivity of uterine segment 2D-TVS was better than that of 3D-TVS, the misdiagnosis rate was significantly lower, which was more consistent with hysteroscopy, but the complete mediastinal uterus and incomplete mediastinum Uterine examination results are exactly the opposite. Conclusions 3D-TVS includes sensitivity and misdiagnosis rate in diagnosing the total detection rate of mediastinal uterus, which is superior to 2D-TVS in consistency with MRI. However, the diagnostic value of 3D-TVS in different genotypes of AFS is Advantage. In view of the fact that the majority of B-ultrasound can take both 2D and 3D diagnosis into consideration, the combination of the two can improve the reliability of diagnosis.