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目的探讨HSG、三维超声和MRI在先天性子宫畸形中的诊断价值。方法回顾性分析经临床或手术证实,有完整HSG、三维超声和MRI影像资料的37例先天性子宫畸形病例。结果 HSG将双子宫误诊为单角子宫1例、误诊为完全纵隔子宫2例,将弓形子宫误诊为不完全纵隔子宫1例、误诊为双角子宫1例,且对残角子宫未能作出诊断,准确率约为64.9%。三维超声将双角子宫误诊为不完全纵隔子宫1例,将弓形子宫误诊为不完全纵隔子宫2例,准确率约为91.9%。MRI将双角子宫误诊为不完全纵隔子宫1例,准确率约为97.3%。结论 HSG诊断子宫畸形的准确率最低,但其可同时评估双侧输卵管通畅与否的优点是其他检查无法替代的;三维超声简便、明确、准确率高,可作为诊断子宫畸形的首选检查方法;MRI可清晰显示先天性子宫畸形的解剖结构,并可通过2D-haste序列轻松判断是否同时伴有泌尿系统畸形,是三者中准确率最高、诊断先天性子宫畸形的最可靠方法,可作为进一步检查。
Objective To investigate the diagnostic value of HSG, three-dimensional ultrasound and MRI in congenital uterine malformation. Methods Retrospective analysis of 37 cases of congenital uterine malformations confirmed by clinical or surgical evidence, complete HSG, three-dimensional ultrasound and MRI images. Results HSG misdiagnosed as a single uterine cervix in 1 case, misdiagnosed as complete mediastinal uterus in 2 cases, misdiagnosed as incomplete uterine segmental uterus in 1 case, misdiagnosed as a double angle uterus in 1 case, and failed to make a diagnosis of residual angle uterus , The accuracy rate is about 64.9%. Three-dimensional ultrasound misdiagnosed double-angle uterus as incomplete mediastinum uterus 1 case, misdiagnosed as incomplete uterine segmental uterus 2 cases, the accuracy rate of about 91.9%. MRI double-angle uterus misdiagnosed as incomplete mediastinal uterus in 1 case, the accuracy rate of about 97.3%. Conclusion The accuracy of HSG in diagnosing uterine malformations is the lowest, but the advantages of HSG in assessing the unilateral tubal patency can not be replaced by other tests. The three-dimensional ultrasonography is simple, accurate and accurate and can be used as the first choice for the diagnosis of uterine malformations. MRI can clearly show the anatomic structure of congenital uterine malformation, and can be easily judged by 2D-haste sequence whether accompanied by urinary malformations, is the highest accuracy of the three, the most reliable method of diagnosis of congenital uterine malformation can be used as a further an examination.