摘要
目的探讨经阴道三维超声(3D-TVS)检查在不同类型宫内节育器(IUD)定型定位中的应用价值,为1次顺利取出IUD提供参考。方法对500例欲取出IUD的围绝经期妇女进行经阴道二维超声(2D-TVS)及3D-TVS检查,观察IUD的形态及其在宫腔内的位置、与子宫肌壁的关系等;超声检查结果与常规手术取器、超声引导下及宫腔镜下取器结果进行比较分析。结果 2D-TVS检查500例IUD,形态完整显示256例,IUD完整显示率51. 20%; 3D-TVS检查IUD形态完整显示492例,IUD完整显示率98. 40%,有8例内膜薄IUD无法清晰完整显示。麻花环组和曼月乐环组2D-TVS、3D-TVS检查IUD完整显示率比较差异无统计学意义(P>0. 05),其余组2D-TVS、3D-TVS检查IUD完整显示率比较差异有统计学意义(P<0. 05)。500例IUD 2D-TVS检查418例位置正常、53例下移,均经3D-TVS检查证实,另外有8例IUD下移由于内膜薄2D-TVS、3D-TVS均不能完整显示; 10例IUD嵌顿或断裂,11例带器妊娠(其中IUD位置3例正常、6例下移、2例嵌顿或断裂),2D-TVS均不能显示完整声像图,3D-TVS可以完整清晰显示。500例IUD经常规手术、超声引导下及宫腔镜下取器均成功,术中所见IUD形态、位置与3D-TVS检查结果一致。结论 3D-TVS检查对IUD形态完整显示率优于2D-TVS,3D-TVS对不同类型IUD的定型和定位诊断具有很高的临床应用价值,对决定取器方案有重要的指导意义。
Objective To explore the application value of transvaginal three-dimensional ultrasonography in form and location of different intrauterine device(IUD)types,provide a reference for smooth removal of IUD once.Methods A total of 500 perimenopausal women preparing for IUD removal underwent transvaginal two-dimensional ultrasonography and transvaginal three-dimensional ultrasonography.IUD shape and location in uterine cavity,the relationship with uterine muscle wall were observed.The results of ultrasonography and conventional operation,the results of ultrasound-guided IUD removal and IUD removal under hysteroscope were compared and analyzed retrospectively.Results A total of 500 cases underwent transvaginal two-dimensional ultrasonography,complete IUD form was observed in 256 cases,the rate was 51.20%;a total of 500 cases underwent transvaginal three-dimensional ultrasonography,complete IUD form was observed in492 cases,the rate was 98.40%,IUD was not observed clearly in 8 cases with thin endometrium.There was no statistically significant difference in display rates of complete IUD form observed by transvaginal two-dimensional ultrasonography and transvaginal three-dimensional ultrasonography between Mahua ring group and Mirena group(P>0.05).There were statistically significant differences in display rates of complete IUD form observed by transvaginal two-dimensional ultrasonography and transvaginal three-dimensional ultrasonography among the other groups(P<0.05).During transvaginal two-dimensional ultrasonography,418 cases of normal position of IUD and 53 cases of declined position of IUD were observed,which were verified by transvaginal three-dimensional ultrasonography,IUD was not observed clearly by transvaginal two-dimensional ultrasonography and transvaginal three-dimensional ultrasonography in 8 cases with declined position of IUD.Complete IUD form was not observed by transvaginal two-dimensional ultrasonography in 10 cases with IUD incarceration or fracture and 11 cases with pregnancy with IUD in situ(3 case
作者
吕丽华
张亦心
刘效群
茹慧波
王玲玲
宗亚芳
李丽辉
LV Li-Hua;ZHANG Yi-Xin;LIU Xiao-Qun;RU Hhuibo;WANG Lingling;ZONG Yafang;LI Lihui(Hebei Reproductive Medicine Center,Shijiazhuang,Hebei 050071,China)
出处
《中国妇幼保健》
CAS
2019年第8期1885-1887,共3页
Maternal and Child Health Care of China
基金
河北省人力资源和社会保障厅资助项目(A2016005069)
关键词
二维超声
三维超声
宫内节育器
图像后期处理
Two-dimensional ultrasound
Three-dimensional ultrasound
Intrauterine device
Image post processing
