核磁共振对早期瘢痕妊娠介入栓塞治疗的术前评价  

Preoperative evaluation of magnetic resonance imaging in the treatment of scar pregnancy by interventional embolization

作　　者：何平[1] 舒建军[1] 王新辉[1] 张剑[1] 杨学俊[1] 李建文 HE Ping;SHU Jianjun;WANG Xinhui;ZHANG Jian;YANG Xuejun;LI Jianwen(Radiology Department,The First People's, Hospital of Shizuishan,Shizuishan 753000,China;Radiology Department,The Second People's Hospital of Shizuishan,Shizuishan 753000,China)

机构地区：[1]宁夏石嘴山市第一人民医院放射科,宁夏石嘴山753000 [2]宁夏石嘴山市第二人民医院放射科,宁夏石嘴山753000

出　　处：《宁夏医学杂志》2018年第12期1147-1149,共3页Ningxia Medical Journal

摘　　要：目的探讨早期瘢痕妊娠(CSP)核磁共振(MRI)特点及其对介入栓塞治疗的术前指导价值。方法收集临床疑似CSP患者20例,行MRI检查,对瘢痕妊娠囊形态、位置进行观察分析,测量瘢痕妊娠囊局部肌层关系、肌层完整性及厚度、与宫颈距离,并对手术方式的选择进行分析。结果 MRI瘢痕妊娠囊分为单纯囊型和混合囊型,9例为单纯囊型,11例为混合囊型; 8例内生型,植入肌层较浅,主要向宫腔内生长,局部肌层厚度5～12mm,12例外生型,孕囊位于瘢痕深处,并向子宫肌层深部生长,局部肌层厚度1～5 mm,其中3例向外突起,肌层厚度1～2 mm,明确内生型及外生型妊娠囊与瘢痕、宫腔、宫颈管及邻近子宫壁的关系。治疗方法:8例内生型中2例植入肌层较浅,采用超声监测下清宫术,18例适合DSA介入治疗,其中3例外生型肌层厚度为1～2 mm,栓塞后行宫腔镜手术治疗,15例栓塞后行清宫术,无并发症发生。结论早期瘢痕妊娠介入栓塞治疗前MRI能够明确孕囊的形态类型、侵入肌层的深度,降低误诊率,指导临床对瘢痕妊娠介入治疗术进行评估。Objective To investigate the MRI features of scar pregnancy( CSP) and evaluate the clinical value of preoperative selective uterine artery embolization. Method The MRI examination of 20 patients with CSP was collected to observe and analyze the shape and position of scar tissue. The local uterine wall thickness and the cervical distance were measured. During the same period,20 patients underwent interventional therapy( including: bilateral uterine artery was slow injected 20 mg methotrexate and embolized the gelatin sponge embolization). The changes of pregnancy cysts and HCG were observed and the therapeutic effect was analyzed.Result MRI showed great results in 20 cases of CSP patients with scar and pregnancy cysts,displaying the cystic and hybrid,the endogenous and exogenous. Exogenous gestation scar was thin,the average thickness was 3 mm,and the thinnest thickness was 1 mm. There were 20 cases of DSA uterine artery embolization,and the effect was satisfied. Conclusion MRI can clearly show the imaging features of scar pregnancy,and make a clear diagnosis. The preoperative interventional treatment of scar pregnancy is of great clinical value.

关 键 词：瘢痕妊娠 核磁共振成像 子宫动脉栓塞 

分 类 号：R714.2[医药卫生—妇产科学]