经阴道三维超声诊断子宫内膜息肉71例.doc

经阴道三维超声诊断子宫内膜息肉71例 韩巧芳 作者单位：东莞市人民医院超声科，广东省东莞市，523059 摘要：目的 探讨经阴道三维超声对子宫内膜息肉的诊断价值。方法 回顾性分析71例经宫腔镜及病理证实的子宫内膜息肉的经阴道三维超声检查的声像图特征。结果 宫腔镜检查息肉直径在3mm~37mm之间，平均直径15±4mm，单发性息肉48例，多发性息肉23例，位于宫腔内46例，位于宫颈管内18例，还有7例位于宫角内；经阴道三维超声诊断子宫内膜息肉68例，漏诊2例，误诊1例，诊断符合率为95.8%。结论 经阴道三维超声是诊断子宫内膜息肉的最为简单安全无创的检查方法，可以作为筛查子宫内膜息肉的首选方法。 关键词：经阴道三维超声；子宫内膜息肉 The diagnosis of endometrial polyps in 71 cases using transvaginal three-dimensional ultrasound HAN Qiaofang Department of Ultrasonography ,Dongguan peoples hospital,Guangdong Dongguan 523059 China ABSTRACT：Objective To investigate the diagnostic value of transvaginal three dimensional ultrasound for endometrial polyps. Methods Retrospectively analysis of transvaginal three dimensional ultrasonic characteristics in 71 cases of endometrial polyps confirmed by hysteroscopy and pathology .Results Hysteroscopy examination polyps diameter in 3 mm ~ 37 mm, average diameter 15 ± 4 mm, single polyp in 48 cases, multiple polyps in 23 cases,46 cases located in the uterine cavity, 18 cases located in the cervical canal ,and 7 cases located in the palace angle；the diagnosis by transvaginal three dimensional ultrasound were 68 cases of endometrial polyps, 2 cases of missed diagnosis and 1 case of misdiagnosis, diagnosis coincidence rate is 95.8%. Conclusions The most simple and safe noninvasive diagnosis method of endometrial polyps is transvaginal three dimensional ultrasound , can be used as a preferred method of screening the endometrial polyps. KEY WORDS：Transvaginal three dimensional ultrasound；Endometrial polyps 子宫内膜息肉是由于子宫内膜的腺体和间质局部增生过度而形成，任何年龄均可发生，但常见于35岁以上的妇女≤10mm）48例，内膜明显不规则增厚（12mm)23例，内膜回声均匀46例，回声不均匀25例，息肉表现为高回声团45例，低回声团13例，还有11例表现为中等回声团。CDFI表现：蒂部可探及条状血流由内膜面伸入息肉内52例（占75%）(见图一)，PW测及动脉性血流频谱，PSV 8-26cm/s，平均15±3cm/s，RI 0.56-0.75，平均0.63±0.08。经阴道三维超声表现：息肉呈高回声团块，起源于子宫内膜面，位于宫腔内，游离面与内膜分界清晰，38例可见粗细不等的蒂部连于内膜面，25例可见宫腔线分离(见图二、图三)。 三.讨论 子宫内膜息肉发病原因尚不明确，一般认为是由于子宫内膜基底层局部增生过长，内膜慢