探讨女性子宫内膜结核的超声声像图特征及诊断意义。

回顾性分析经手术及病理证实为子宫内膜结核的患者47例。所有患者均行经阴道彩色多普勒超声检查，总结分析子宫内膜形态特征、内部回声及血流等情况的超声声像图特征和表现，并对子宫内膜结核患者盆腹腔内的其他超声表现及术中所见进行分析。

经阴道超声检查47例患者的子宫内膜厚度，单层内膜厚度平均为（0.31±0.15）cm。根据超声影像特点，子宫内膜表现为不同特征，其中15例（31.9%）主要表现为子宫内膜回声不均匀，12例（25.5%）主要表现为宫腔内结节样病灶，8例（17.0%）主要表现为宫腔内的强回声灶，12例（25.5%）主要表现为单纯的子宫内膜薄。子宫内膜结核患者盆腹腔内的其他超声表现有：43例（91.5%）伴有输卵管炎性表现，11例（23.4%）伴有输卵管系膜囊肿，9例（19.1%）伴有盆腔包裹性积液；术中所见有：45例（95.7%）伴有盆腹腔组织粘连，23例（48.9%）伴有盆腹腔粟粒样结节。

子宫内膜结核超声表现多样，但缺乏特异性的征象，需结合患者病史及进一步的临床检查，才能明确诊断，合并输卵管异常的超声征象对提高其诊断率具有一定的参考价值。

To study the image features and diagnostic value of ultrasound in endometrial tuberculosis.

The ultrasound features of endometrial tuberculosis in 47 cases confirmed by operative pathology were reviewed retrospectively. All patients were examined by transvaginal color Doppler ultrasonography. The ultrasound features of endometrial morphology, internal echo and blood flow were summarized and analyzed. In addition, the ultrasound and intraoperative findings in the pelvic and abdominal cavity were also analyzed.

The endometrial thickness of 47 patients was measured by transvaginal ultrasonography and the average thickness of monolayer endometrium was (0.31±0.15) cm. According to the findings on ultrasound images, 15 cases (31.9%) showed heterogeneous endometrial echo-texture, 12 cases (25.5%) showed intrauterine nodular lesions, 8 cases (17.0%) showed intrauterine echogenic focus, and 12 cases (25.5%) presented with thin endometrium. Additional ultrasonic findings of endometrial tuberculosis in the pelvic and abdominal cavity included 43 cases (91.5%) with fallopian tube inflammatory lesions, 11 cases (23.4%) with mesosalpinx cyst, and 9 cases (19.1%) with pelvic encapsulating effusion. The intraoperative findings included 45 cases (95.7%) with pelvic and abdominal tissue adhesion, and 23 cases (48.9%) with pelvic and abdominal miliary nodules.

The endometrial tuberculosis showed various ultrasonic manifestations without any specific features. Thus, it is necessary to make a comprehensive analysis of the patient′s medical history and clinical examinations to reach the final diagnosis, in which ultrasound findings of oviduct tuberculosis can provide very helpful diagnostic information.