Chertin B, Hadas-Halpern I, Fridmans A, Kniznik M, Abu-Arafeh W, Zilberman M, Farkas A
Department of Urology, Shaare Zedek Medical Center, P.O.B. 3235, Jerusalem 91031, Israel.
J Clin Ultrasound. 2000 Mar;28(3):122-4. doi: 10.1002/(sici)1097-0096(200003/04)28:3<122::aid-jcu3>3.0.co;2-t.
We assessed the clinical value of transabdominal pelvic sonography in the preoperative evaluation of patients with congenital adrenal hyperplasia (CAH) who required feminizing genitoplasty.
From 1987 to 1998, 31 patients with female pseudohermaphroditism due to CAH underwent feminizing genitoplasty. The median age of the patients was 9 months (range, 1-18 years). Radiologic evaluation performed before surgical reconstruction included retrograde genitography in the first 10 patients and sonographic examination in all 31 patients. Imaging was used to evaluate the anatomic positions and the length of the vagina, whether the junction of the vagina and the urogenital sinus occurred distal or proximal to the pelvic floor, and the presence of internal genitalia.
Abdominal sonography identified internal female genitalia in all 31 patients, identified the anatomic shape and position of the vagina in 30 patients (97%), and confirmed the site of communication between the vagina and the urogenital sinus relative to the pelvic floor in 28 patients (90%). Sonographic findings were confirmed by intraoperative panendoscopy. Genitography was less useful than sonography, identifying the site of communication between the vagina and urogenital sinus in only 6 (60%) of 10 patients.
In patients with CAH undergoing vaginal reconstruction, sonography provides adequate information about the anatomy of the vagina and urogenital sinus for surgical decision-making.
我们评估了经腹盆腔超声检查在需要女性化生殖器成形术的先天性肾上腺皮质增生症（CAH）患者术前评估中的临床价值。
1987年至1998年，31例因CAH导致的女性假两性畸形患者接受了女性化生殖器成形术。患者的中位年龄为9个月（范围1 - 18岁）。手术重建前进行的放射学评估包括前10例患者的逆行性生殖器造影和所有31例患者的超声检查。影像学检查用于评估阴道的解剖位置和长度、阴道与泌尿生殖窦的连接处位于盆底远端还是近端以及内生殖器的存在情况。
腹部超声检查在所有31例患者中均识别出女性内生殖器，在30例患者（97%）中确定了阴道的解剖形状和位置，在28例患者（90%）中确认了阴道与泌尿生殖窦相对于盆底的连通部位。超声检查结果经术中全内镜检查证实。生殖器造影比超声检查的作用小，仅在10例患者中的6例（60%）中识别出阴道与泌尿生殖窦的连通部位。
对于接受阴道重建的CAH患者，超声检查可为手术决策提供有关阴道和泌尿生殖窦解剖结构的充分信息。
