MRI在剖宫产术后瘢痕妊娠中的诊断价值(附30例分析)  

The Diagnosis Value of MRI in Post C-sect Scar Gestation

作　　者：原仲晖[1] 陈晓东[2] 黄波涛[1] 敖振杰[1] 黄炎标[1] 区俊兴[1] 

机构地区：[1]广东省东莞市厚街医院放射科,523962 [2]广东医学院附属医院放射科,524001

出　　处：《现代医用影像学》2015年第5期714-717,共4页Modern Medical Imageology

摘　　要：目的:探讨MRI在剖宫产术后瘢痕妊娠中的诊断价值。材料与方法:对照手术病理结果,回顾性分析30例拟诊瘢痕妊娠的临床资料和MRI图像。结果:经手术病理证实,30例均为瘢痕妊娠,准确率100%,孕囊均位于子宫前下壁峡部,T1WI以等低信号为主,T2WI以稍高或高信号为主,DWI可为低信号、高信号或囊壁高信号。子宫瘢痕在MRI常规序列呈低信号,增强后无强化。30例瘢痕妊娠中合并绒毛或胎盘植入的5例,显示为子宫增大,于T2WI变薄的子宫肌层内出现高信号灶,可伴花瓣样、结节状强化或不强化坏死区。结论:MRI能很好的显示子宫瘢痕、孕囊的位置、相邻的子宫肌层信号和厚度的改变及是否合并绒毛或胎盘植入,为临床治疗方案提供依据。Purpose： to explore the diagnostic value of MRI in cesarean scar pregnancy （CSP）. Materials and Methods ： the clinical data and MRI images of 30 cases of patients with CSP were retrospectively analyzed and compared to the resuhs of surgical pathology. Results： confirmed by surgery pathology, all 30 cases were scar pregnancy with 100% accuracy. All gestational sac were located at the scar of lower anterior uterus isthmus with equal or lower signal on T1WI, little high or hyper - intensity on T2WI, low or high signals on diffusion weighted imaging （DWI） and without enhancement on enhanced scan. In 30 cases of CSP patients, 5 cases combined with nap or placenta accreta, shown as the uterus increases and the focal high signal in the thinning myometrium on T2WI accompanied with petals, nodular necrotic area with or without enhancement. Conclusion ： MRI can well display the location of the uterine scar and pregnant bursa, the adjacent myometrium signal and the change of the thickness as well as the nap or placenta accreta, providing the basis for clinical treatment.

关 键 词：瘢痕妊娠 MRI 胎盘植入 

分 类 号：R714.22[医药卫生—妇产科学] R445.2[医药卫生—临床医学]