阴道超声检查诊断获得性子宫血管动静脉瘘的价值

摘要

目的探讨阴道超声检查诊断获得性子宫血管动静脉瘘的价值.方法回顾性分析46例有既往子宫创伤(流产或剖腹产)及滋养细胞疾病史而形成子宫及宫旁动静脉瘘,并导致阴道出血患者的彩色多普勒腔内超声检查结果：病变部位的范围、彩色血流及频谱多普勒的特点；收缩期最大血流速度(PSV)、舒张期最小血流速度(EDV)和阻力指数(RI).结果子宫及宫旁动静脉瘘病变部位均显示局限性静脉扩张,呈迂曲管状或囊状无回声区,彩色多普勒血流显像病灶显示为动静脉瘘区五彩镶嵌血流信号,脉冲多普勒示瘘口处探及高速低阻动脉频谱,血流丰富；PSV (88.57±28.82)cm/s,EDV(52.94±15.36)cm/s,RI(0.41±0.05).结论子宫动静脉瘘是创伤性子宫异常出血的原因之一,腔内彩色多普勒超声有其特征性表现,有诊断价值.%Objective To study the clinical value of transvaginal ultrasonography in the diagnosis of acquired uterine arteriovenous fistulas with massive vaginal bleeding. Method 46 patient with acquired uterine and parauterine arteriovenous fistulas caused by uterine trauma like artificial abortion and caesarean section and malignant trophoblastic disease underwent color Doppler sonography. The features and Doppler signals were retrospectively analyzed. The index include peak systolic velocity(PSV),end-diastolic velocity(EDV)and resistance index(RI). Results Arteriovenous fistulas demonstrate a mosaic pattern representing turbulent flow. Spectral analysis of intralesional arterial flow demonstrates high-velocity flow with alow resistive index,and spectral analysis of intralesional venous flow shows high peak systolic velocities consistent with an arterial flow pattern. PSV:(88.57±28.82) cm/s;EDV:(52.94±15.36)cm/s;RI:(0.41±0.05). Conclusion Uterine arteriovenous fistulas can be the cause of irregularly vaginal bleeding,transvaginal color Doppler sonography has its own features.