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目的探讨经阴道超声和子宫输卵管造影(HSG)在诊断子宫畸形中的价值。方法收集2009年4月至2010年12月在复旦大学附属妇产科医院因不孕就诊的患者共61例,均进行经阴道超声检查和子宫输卵管造影术(HSG)检查,所有患者进一步做宫腔镜或宫腹腔镜联合检查确诊,从而对比两种检查方法的诊断准确率及误诊率。结果经阴道超声和HSG对单角子宫的误诊率均为7.0%,符合率均为95.1%;经阴道超声对双子宫的漏诊率为0%,符合率为100.0%,而HSG对双子宫的漏诊率为10.0%,符合率为96.7%;经阴道超声对纵隔子宫的漏诊率0%,符合率为100.0%,而HSG对纵隔子宫的漏诊率为15.0%,符合率为91.8%。结论经阴道超声检查对纵隔子宫、双子宫等子宫畸形的诊断符合率高于HSG,是准确、无创的检查方法。对于复杂的、不典型的子宫畸形,上述两种方法诊断还有一定困难,还需要结合宫腔镜或宫腹腔镜联合明确诊断。
Objective To investigate the value of transvaginal sonography and hysterosalpingography (HSG) in the diagnosis of uterine malformations. Methods A total of 61 inpatients with infertility at Affiliated Obstetric and Gynecology Hospital of Fudan University from April 2009 to December 2010 were enrolled in this study. Transvaginal sonography and hysterosalpingography (HSG) were performed in all patients. Endoscopy or laparoscopic diagnosis of laparoscopic examination, which compared the diagnostic accuracy of both methods and misdiagnosis rate. Results The misdiagnosis rates of single angle uterus by transvaginal sonography and HSG were 7.0% and the coincidence rates were 95.1%. The rate of misdiagnosis of double uterus by transvaginal ultrasound was 0% and the coincidence rate was 100.0% The rate of misdiagnosis was 10.0% and the coincidence rate was 96.7%. The rate of misdiagnosis of mediastinal uterus by transvaginal ultrasound was 0% and the coincidence rate was 100.0%. The misdiagnosis rate of HSG to mediastinum was 15.0% and the coincidence rate was 91.8%. Conclusions Transvaginal ultrasonography is the accurate and noninvasive method for the diagnosis of uterine malformations such as mediastinal uterus and double uterus. For complex, atypical cases of uterine malformations, the diagnosis of the two methods there are still some difficulties, but also need to combine hysteroscopy or laparoscopic clear diagnosis.