目的探讨经阴道三维超声对子宫畸形的诊断价值。方法选择已临床确诊的130例子宫畸形患者,年龄26~42岁,平均年龄33岁。单角和/或残角子宫均经过宫腔镜和/或腹腔镜检查确诊,双子宫、双角子宫、鞍形子宫均经过MRI检查确诊,纵隔子宫经过宫腔镜检查确诊。回顾分析其经阴道二维和三维超声图像资料。结果经阴道三维超声诊断单角子宫和/或残角子宫11例,双子宫6例,双角子宫7例,纵隔子宫80例,鞍形子宫25例。经阴道二维超声诊断单角子宫和/或残角子宫5例,双子宫6例,双角子宫6例,纵隔子宫73例,鞍形子宫5例。经阴道三维超声诊断与宫腔镜结果符合率99.23%,显著高于二维超声诊断73.08%;两者相比,差异有统计学意义(P<0.005)。结论经阴道三维超声图像可以显示不同子宫畸形的宫腔结构及宫底的外观形态,是诊断先天性子宫畸形的无创性可靠方法之一。 Objective To investigate the value of transvaginal three-dimensional ultrasound in the diagnosis of uterine malformations. Methods 130 clinically diagnosed cases of uterine malformations, aged 26 to 42 years, mean age 33 years. Single and / or residual horn uterus were confirmed by hysteroscopy and / or laparoscopy, double uterus, double angle uterus, saddle-shaped uterus were confirmed by MRI examination, mediastinum uterus confirmed by hysteroscopy. Retrospective analysis of its transvaginal two-dimensional and three-dimensional ultrasound image data. Results Transvaginal three-dimensional ultrasound diagnosis of unicorrha and / or rudimentary horn in 11 cases, double in 6 cases, double horns in 7 cases, 80 cases of mediastinal uterus, 25 cases of saddle-shaped uterus. Transvaginal two-dimensional ultrasound diagnosis of unicorns and / or remnant horns in 5 cases, 6 cases of double uterus, 6 cases of double angle uterus, 73 cases of mediastinal uterus, 5 cases of saddle-shaped uterus. The coincidence rate of transvaginal three-dimensional ultrasound and hysteroscopy was 99.23%, which was significantly higher than that of two-dimensional ultrasound 73.08%. The difference was statistically significant (P <0.005). Conclusion Transvaginal three-dimensional ultrasound images can show the uterine cavity structure and uterine appearance of different uterine malformations, is one of the noninvasive and reliable methods for the diagnosis of congenital uterine malformations.