经会阴实时三维超声在会阴区囊实性病变中的应用研究

doi:10.3877/cma.j.issn.1674-3253.2018.03.010

中华腔镜泌尿外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 185 -189. doi: 10.3877/cma.j.issn.1674-3253.2018.03.010

所属专题：文献；

临床研究

经会阴实时三维超声在会阴区囊实性病变中的应用研究

甘宜鑫¹, 张新玲¹^,^†(

), 周祥福²

^1. 510630　广州，中山大学附属第三医院超声科
^2. 510630　广州，中山大学附属第三医院泌尿外科

收稿日期:2017-06-26 出版日期:2018-06-01
通信作者: 张新玲

Application of the real-time three-dimensional transperineal ultrasonography in the diagnosis of perineal cystic-solid lesion

Yixin Gan¹, Xinling Zhang¹^,^†(), Xiangfu Zhou²

^1. Department of Ultrasound, the Third Affliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
^2. Department of Urology, the Third Affliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China

Received:2017-06-26 Published:2018-06-01
Corresponding author: Xinling Zhang
About author:
Corresponding author: Zhang Xinling, Email: zhxll205@126.com

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目的

探讨经会阴实时三维超声在会阴区囊实性病变诊断及鉴别诊断中的临床价值。

方法

回顾分析219例经手术、临床确诊为会阴区囊实性病变并进行了经会阴实时三维超声检查的女性患者声像图表现，总结不同会阴区囊实性病变声像图特点。

结果

经会阴实时三维超声可以清晰显示会阴区囊实性病变。219例被检者中，阴道壁囊肿33例、尿道旁囊肿7例、尿道憩室7例、膀胱膨出58例、阴道内肿瘤4例、子宫脱垂32例、会阴体过度运动52例、直肠膨出26例。阴道壁囊肿、尿道腺囊肿在声像图上均表现为尿道旁的类椭圆形无回声或低回声区，与尿道及阴道均不相通；尿道憩室在声像图上表现为尿道旁不规则的无回声或低回声区，与尿道相通；阴道内肿瘤表现为阴道内不规则的低回声区；膀胱膨出、子宫脱垂、会阴体过度运动、直肠膨出表现为相应器官下移至参考线下。

结论

经会阴实时三维超声能够客观反映会阴区囊实性病变的不同声像特征，有助于临床诊断及鉴别诊断，具有一定的临床实用价值。

关键词: 会阴区, 囊实性病变, 超声, 诊断

Objective

To explore the clinical value of real-time three-dimensional transperineal ultrasonography in the diagnosis of perineal cystic-solid lesion.

Methods

Ultrasonographic performances of 219 female patients who were diagnosed as periurethral cystic lesions by surgical and clinical diagnosis and received perineal real-time three-dimensional ultrasonography were retrospectively analyzed, and ultrasonographic features of different perineal cystic-solid lesion were summarized.

Results

Perineal cystic-solid lesion could be shown clearly by perineal real-time three-dimensional ultrasonography. Among the 219 patients, 33 patients with vaginal wall cysts, 7 patients with paraurethral cysts, 7 patients with urethral diverticulum, 58 patients with cystocele, 4 patients with intravaginal tumor, 32 patients with uterine prolapse, 52 patients with perineal hypermobility, and 26 patients with rectocele, vaginal wall cysts and periurethral cysts manifested as periurethral oval-like anechoic or hypoechoic area, and didn't connect with urethra and vagina. Urethral diverticulum in the sonogram echogram manifested as irregular periurethral anechoic or hypoechoic area, and connected with urethra. Intravaginal tumor manifested as irregular hypoechoic areas in the vagina. Cystocele, uterine prolapse, perineal hypermobility and rectocele manifested as the velative organs moved down under the reference line.

Conclusion

The real-time three-dimensional ultrasonography is effective for diagnosis and differential diagnosis of perineal cystic-solid lesion.

Key words: Perineal, Cystic-solid lesion, Ultrasound, Diagnosis

图6 尿道旁可见不规则形无回声（C），与尿道（U）相通，尿道和憩室之间存在通道（手指所示）（轴平面3D）

图12 TUI模式下，多个连续平行平面观察显示尿道憩室与尿道间的窦道（箭头所指）

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Application of the real-time three-dimensional transperineal ultrasonography in the diagnosis of perineal cystic-solid lesion