Senoh D, Yanagihara T, Hata T
Department of Obstetrics and Gynaecology, Shimane Medical University, Izumo, Japan.
Gynecol Obstet Invest. 1999;47(2):108-13. doi: 10.1159/000010072.
Our purpose was to determine whether intrauterine sonography with high-frequency, real-time miniature transducer (20 MHz) is useful for the diagnosis of gynecologic disorders. The study consisted of 37 women: 8 normal volunteers, 2 with molar pregnancy, 4 fibromyoma, 4 endometrial polyp, 1 intrauterine adhesion, 1 septate uterus, 5 atypical hyperplasia, 8 endometrial cancer, and 4 with cervical cancer. Comparison of diagnostic efficacy for gynecologic disorders between transvaginal and intrauterine sonography was made. The probe was easily introduced into the endometrial cavity in all patients. No notable complications were encountered. In subjects with a normal uterus, higher resolution for endometrial texture was obtained with intrauterine sonography than with transvaginal scanning. In patients with molar pregnancy, typical vesicular echoes were clearly identified. In patients with fibromyoma, myoma nodules were not clearly visualized because of poor attenuation of ultrasound. In subjects with endometrial polyp, intrauterine adhesion, and septate uterus, intrauterine lesions were clearly identified. In patients with atypical hyperplasia, high echogenicity of the endometrium was characterized. Myometrial invasion of the endometrial cancer was estimated correctly in 6 of 8 patients (75%). Intrauterine sonography could clearly detect early cervical invasion of the cervical cancer in all 4 patients, but transvaginal sonography could not do it. Intrauterine sonography with a high-frequency, real-time miniature transducer might be a useful diagnostic modality in gynecologic disorders, especially in the evaluation of early cervical cancer, endometrial cancer, and possibly in infertility practice.
我们的目的是确定使用高频实时微型探头（20兆赫）进行子宫内超声检查对妇科疾病的诊断是否有用。该研究包括37名女性：8名正常志愿者、2名葡萄胎患者、4名子宫肌瘤患者、4名子宫内膜息肉患者、1名子宫内粘连患者、1名纵隔子宫患者、5名非典型增生患者、8名子宫内膜癌患者和4名宫颈癌患者。对经阴道超声检查和子宫内超声检查在妇科疾病诊断效能方面进行了比较。在所有患者中，探头都能轻松插入子宫内膜腔。未遇到明显并发症。在子宫正常的受试者中，子宫内超声检查对子宫内膜质地的分辨率高于经阴道扫描。在葡萄胎患者中，典型的水泡样回声清晰可见。在子宫肌瘤患者中，由于超声衰减不佳，肌瘤结节未清晰显示。在子宫内膜息肉、子宫内粘连和纵隔子宫的受试者中，子宫内病变清晰可见。在非典型增生患者中，子宫内膜表现为高回声。8例子宫内膜癌患者中有6例（75%）正确估计了肌层浸润情况。子宫内超声检查能在所有4例患者中清晰检测到宫颈癌的早期宫颈浸润，但经阴道超声检查则无法做到。使用高频实时微型探头进行子宫内超声检查可能是妇科疾病的一种有用诊断方法，尤其在早期宫颈癌、子宫内膜癌的评估中，可能在不孕症诊疗中也有用。
