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目的探讨多种影像学方法术前诊断不同孕周残角子宫妊娠的应用价值。方法该院近10年就诊孕5~22周残角子宫妊娠21例,所有病例术前经常规腹部彩超联合阴道三维彩超做出超声诊断,必要时行核磁共振检查诊断,对照临床术后诊断,分析多种影像学方法诊断孕周不同的残角子宫妊娠价值。结果 21例患者术后均确诊为残角子宫妊娠,对照术前影像学诊断:1孕5~16周19例经腹部彩超联合阴道三维彩超诊断无误诊,仅经腹部彩超诊断1例漏诊,2例误诊。2≥16周的2例患者彩超提示残角子宫可疑,1例进一步行核磁共振检查后确诊。结论阴道三维彩超较常规腹部彩超更清晰、立体地显示了解剖关系,联合应用适用于孕16周前的影像学诊断;孕16周后,采用超声联合核磁共振的方法有利于明确术前诊断。
Objective To explore the value of multiple imaging methods for the preoperative diagnosis of rudimentary horns uterine pregnancy of different gestational weeks. Methods In the past 10 years, 21 cases of rudimentary horns uterine pregnancy were observed in 5 ~ 22 weeks of pregnancy in our hospital. Ultrasound was performed in all cases by conventional abdominal ultrasonography combined with vaginal three-dimensional color Doppler ultrasound. If necessary, MRI was used to diagnose, Analysis of a variety of imaging methods to diagnose different gestational weeks residual angle uterine pregnancy. Results All the 21 cases were diagnosed as residual horn uterine pregnancy. The control group was diagnosed preoperatively: 19 cases of 5 weeks to 16 weeks of pregnancy, 19 cases were diagnosed by color Doppler ultrasonography combined with vaginal three-dimensional ultrasonography without misdiagnosis. Only 1 case was diagnosed by abdominal ultrasonography, Cases of misdiagnosis. 2 ≥ 16 weeks of 2 cases of color Doppler ultrasound remnant horns uterus suspicious, and 1 case further confirmed by MRI. Conclusions Vaginal 3D ultrasound can clearly and stereoscopically display the anatomic relationship with conventional abdominal ultrasonography. The combined application is suitable for imaging diagnosis 16 weeks before gestation. After 16 weeks of gestation, ultrasound and MRI can be used to confirm the preoperative diagnosis.