经阴道三维超声诊断宫内节育器异常的临床应用

摘要

目的:探讨诊断宫内节育器 (intrauterine contraceptive device, IUD) 异常时应用经阴道三维超声的临床意义.方法:对经阴道二维超声高度怀疑IUD异常的99例患者进行经阴道三维超声检查, 观察IUD的形态、位置及其与宫腔、肌层的关系, 以宫腔镜、腹腔镜或手术结果为金标准, 分析经阴道三维超声成像的准确率.结果:三维超声检查诊断准确率为98.99％ (98/99), 其中检查位置正常28例, 下移6例, 嵌顿60例, 旋转1例, 部分穿孔3例, 误诊1例 (由于子宫肌腺症合并子宫肌瘤导致宫腔形态异常误认为IUD嵌顿) ;二维超声正确诊断70例, 准确率为70.71％, 明显低于三维超声的98.99％ (P＜0.01) .结论:经阴道三维超声诊断IUD异常显示更清晰, 准确率更高, 具有重要的应用价值.%Objective:To analyze the value of transvaginal three-dimensional ultrasonography in the diagnosis of abnormal intrauterine device (IUD) position.Method:A total of 99 patients with highly suspected abnormal IUD were examined by transvaginal three-dimensional ultrasonography.The morphology, location and relationship between IUD and uterine cavity and muscular layer were observed.The accuracy rate of transvaginal three-dimensional ultrasound imaging was analyzed by using surgical results.Result:The diagnostic accuracy rate of transvaginal three-dimensional ultrasonography was 98.99％ (98/99), including 28 cases with normal position, 6 cases with lower position, 60 cases with incarceration, 1 case with rotation, 3 cases with partial perforation, and 1 case with misdiagnosis (abnormal uterine cavity morphology caused by uterine fibroids was mistaken for the incarceration of IUD).The correct diagnosis rate of 70 cases with two-dimensional ultrasound was 70.71％, which was significantly lower than 98.99％ of three-dimensional ultrasound (P＜0.01).Conclusion:Transvaginal threedimensional ultrasound in the diagnosis of abnormal IUD position shows more clearly, higher accuracy, and has an important application value.