经腹及经阴道超声联合应用对剖宫产术后切口瘢痕妊娠的诊断价值  

Transabdominal and Transvaginal Ultrasonic Examination of Cesarean Scar Pregnancy

作　　者：宋玲[1] 龚明[1] 余本英 

机构地区：[1]贵阳中医学院第一附属医院超声室,贵阳市550001 [2]修文县人民医院超声室

出　　处：《中国超声医学杂志》2010年第6期570-572,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨应用经腹及经阴道超声对剖宫产术后切口瘢痕妊娠的诊断价值。方法对18例剖宫产术后切口瘢痕妊娠经手术病理及保守治疗所证实,根据声像图表现特征与分型进行回顾性分析。结果 18例剖宫产术后切口瘢痕妊娠,经腹及经阴道超声检查,超声显示率分别为72.2%(13/18)、83.3%(15/18),其中单纯妊娠囊型9例,占50%(9/18)、混合回声包块型4例,占22.2%(1/18),部分位于子宫腔型2例,占11.1%(2/18)。漏诊3例,占16.7%(3/18),分别为2例宫颈妊娠,占11.1%(2/18),1例为恶性滋养细胞疾病,占5.6%(1/18)。结论经阴道超声检查能够弥补经腹超声检查不足,2种检查技术联合应用可提高剖宫产术后切口瘢痕妊娠的超声诊断符合率。超声检查能够清晰显示剖宫产术后切口瘢痕妊娠的位置,范围,子宫肌层厚度及血供情况,及时诊断,并能动态观察治疗效果,具有重要临床应用价值。Objective To explore the clinical value of transabdominal and transvaginal ultrasonic on cesarean scar pregnancy. Methods Through pathologic results and conventional therapy, according to ultrasonic features and type-study, 18 cases of cesarean scar pregnancy were reviewed retrospectively. The sonographic appearance showed 9 cases were gestational sac-type and 3 cases were mixed mass-type. Results Through transabdominal and transvaginal ultrasonic examination of these 18 cesarean scar pregnancy, ultrasound display rate was 72.2% （13/18） and 83.3%, retrospectively, among which 9 cases were gestational sac-type, 50% of all the cases （9/18）, 4 mixed mass-type cases, 20% of all the cases （4/18）, 2 cases were uterine cavity, 11.1% of all the cases （2/18） and 3 cases were misdiagnosed, 16.7% of all the cases （3/18） among which 2 were cervicalpregnancy, 11.1% of all the cases and 1 malignant trophoblastic disease, 5.6% of all the cases （1/18） . Conclusions Transvaginal ultrasonic examination can make up the shortcoming of transabdominal ultrasound. This combination can improve diagnosing coincidence of cesarean scar pregnancy. Ultrasonic examination can show clearly the position, range, cesarean thickness and blood supply of cesarean scar pregnancy, meanwhile it can be with real time accurate diagnosis and dynamicly observing treatment effects, which is valuable in clinical diagnosis.

关 键 词：超声诊断 剖宫产术后切口瘢痕妊娠 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]