静脉超声造影在子宫剖宫产后瘢痕妊娠中的临床应用  

The Clinical Application of Intravenous Contrast-enhanced Ultrasound in Uterine Cesarean Scar Pregnancy

作　　者：李慧东[1] 张志坤[1] 杨华[1] 郭爽[1] 柴义青[1] 

机构地区：[1]天津市中心妇产科医院,300100

出　　处：《国际妇产科学杂志》2015年第3期355-357,共3页Journal of International Obstetrics and Gynecology

基　　金：天津市卫生局科技基金(2012KY38)

摘　　要：目的:探讨静脉超声造影在子宫剖宫产后瘢痕妊娠中的临床应用价值。方法:对20例可疑子宫剖宫产瘢痕妊娠的病例进行静脉超声造影检查,造影剂为意大利Bracco公司生产的第二代声学造影剂声诺维(Sono Vue),造影时重点观察病灶处造影剂的增强与消退情况,记录灌注模式以及病灶与子宫浆膜层、肌层的关系。结果:瘢痕妊娠病灶类型可分为胎囊型与包块型。超声造影显示,相对于子宫肌层而言,病灶处均为早增强、高增强;增强模式为快进慢出;当切口处病灶与肌层关系在二维超声下辨别不清时,造影可显示肌层与浆膜层是否完整以及病灶是否已侵入肌层,甚至浆膜层。结论:静脉超声造影可以明确诊断瘢痕妊娠,进而提供更丰富的信息指导治疗。Objective：To investigate the clinical value of intravenous contrast-enhanced ultrasound（CEUS） in uterine cesarean scar pregnancy. Methods：The CEUS were performed in 20 cases of suspected pregnancy within uterine cesarean.Contrast agents were the second generation of acoustic contrast agent Sono Vue made in Italian Bracco company. The agents appearance and disappearance time and intensity in the leision,perfusion pattern and the relationship between lesion and serosa layer/muscular layer,were observed. Results：The lesions types can be divided into gestation sac type and mass type. The CEUS shows that high intensity and fast accumulation of contrast agents are observed in cesarean leisions,compared with myometrium nearby. Contrast model is fast entrance and slow disappear;The CEUS can also identify the integrity of serosal layer and muscular layer,and the intrusion or not of the lesion to the muscular layer, even serosal layer,while the 2D-ultrasound can not distinguish the verge of leisions and muscular layer. Conclusions：The CEUS can give more important diagnositic information in caesarean scar pregnancy,and guide clinical treatment followed.

关 键 词：瘢痕妊娠 超声造影 造影剂 剖宫产术 

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]