彩色多普勒超声对高强度聚焦超声治疗剖宫产瘢痕妊娠的疗效观察  

Color Doppler ultrasonographic observation on effect of high intensity focused ultrasound for treatment of cesarean scar pregnancy

作　　者：朱剑芳[1] 周伟芳[1] 秦军丽[2] 汪芳[3] 石珍[2] 周金水[3] 

机构地区：[1]南昌大学第一附属医院超声科,江西南昌330006 [2]南昌大学第一附属医院妇产科,江西南昌330006 [3]南昌大学第一附属医院肿瘤科,江西南昌330006

出　　处：《中国医学影像技术》2013年第3期463-466,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨彩色多普勒超声观察高强度聚焦超声(HIFU)治疗剖宫产术后瘢痕妊娠疗效的价值。方法分析20例经超声诊断子宫瘢痕妊娠患者HIFU治疗前、治疗后1周、4周的彩色多普勒超声声像图,并对其周边血流阻力指数(RI)及血人绒毛膜促性腺激素(T-HCG)值进行统计分析。结果 14例胚囊型治疗后孕囊塌陷、变形、胚芽未见长大,6例卵黄囊回声稍增强、壁增厚,血流轻度减少;6例包块型治疗后回声先稍增高,而后中央区回声减低,最终表现为稍高回声,血流明显减少。治疗后1周、4周RI均高于治疗前,治疗后4周RI高于治疗后1周(P均<0.05);但T-HCG在治疗前后差异均无统计学意义(P均>0.05)。结论彩色多普勒超声对HIFU治疗剖宫产术后瘢痕妊娠的疗效观察及随访具有临床价值。Objective： To explore the efficacy of high intensity focused ultrasound （HIFU） for the treatment of cesarean scar pregnancy by color Doppler ultrasonography. Methods： Ultrasonic appearances and hemodynamic parameter of 20 patients with CSP confirmed by ultrasound were analyzed retrospectively. The corresponding T-HCG, the peripheral blood flow resistance index （RI） were analyzed statistically before HIFU treatment, 1 week and 4 weeks after treatment. Results： In 14 patients with embryo sac, the gestation sac and embryo collapsed after HIFU treatment, and the echo of yolk sac slightly increased with wall thickening and blood flow slightly reducing in 6 patients. Echo of asymmetrical mass increased firstly in 6patients, then lower echo was found in the center, and finally a little higher echo with significantly reduced blood flow were detected. RI increased gradually after HIFU treatment （all P〈0.05）. No statistical differences of T-HCG was found before and after treatment （P〉0.05）. Conclusion： Color Doppler ultrasound plays an important role in evaluating the therapeutic effect of HIFU and follow-up of patients with CSP.

关 键 词：剖宫产术 妊娠 异位 高强度聚焦超声消融 治疗结果 

分 类 号：R719.8[医药卫生—妇产科学] R445.1[医药卫生—临床医学]