分析对比经阴道超声与磁共振诊断瘢痕妊娠的临床价值  

Clinical value comparison and analysis of transvaginal ultrasound and magnetic resonance imaging in cesarean scar pregnancy

作　　者：王思宇[1] 唐少珊[1] 吕慧娜[1] 

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《生物医学工程与临床》2017年第4期368-372,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨经阴道超声及MRI对剖宫产术后瘢痕妊娠(CSP)的诊断价值。方法选择80例手术后病理组织诊断均为符合子宫瘢痕处妊娠(绒毛滋养叶细胞及蜕膜组织)患者,年龄21~45岁,平均年龄31.33岁。孕1~7次,既往剖宫产次数1~2次。观察经阴道超声和MRI的表现,对比分析两种诊断方法的诊断效能。结果 80例患者经MRI及阴道超声检查均清楚显示在子宫宫腔下段剖宫产瘢痕部位存在异常回声。80例患者手术前有78例经阴道超声诊断为CSP,2例为宫颈管包块(准确率为97.5%)。74例经MRI诊断为CSP,1例为宫颈妊娠,4例为囊性结构,1例为积血(准确率为92.5%)。二者诊断效能比较,差异无统计学意义(P>0.05)。结论经阴道超声检查是早期诊断CSP的有效方法 ,与MRI有相同的诊断效能。Objective To evaluate the diagnostic value of transvaginal ultrasound and magnetic resonance imaging（MRI） in cesarean scar pregnancy（CSP）. Methods A total of 80 uterine scar pregnancy by postoperative pathological diagnosis（villous trophoblast and decidual tissue） were enrolled, aged 21-45 years old with mean age of 31.33 years old. Pregnancy of 1-7times and previous cesarean section was 1-2 times. Transvaginal ultrasound and MRI performances were compared, and the diagnostic efficiency of 2 methods was analyzed. Results All of 80 patients were observed abnormal echoes from cesarean section scar in uterine cavity by transvaginal ultrasonography and MRI. Seventy-eight cases were diagnosed as CSP, 2 cases as cervical tube mass by transvaginal ultrasound method before operation（accuracy rate was 97.5 %）. Seventy-four cases were diagnosed as CSP, 1 case as cervical pregnancy, 4 cases as cystic mass and 1 case as hematocele by MRI before operation（accuracy rate was 92.5 %）. There was no statistically significant difference between 2 diagnostic methods（P 〉 0.05）. Conclusion It is demonstrated that transvaginal ultrasound is an effective method for early diagnosis of CSP, which showed the same diagnosis efficacy with MRI.

关 键 词：子宫 瘢痕妊娠 剖宫产术 磁共振成像 经阴道超声 

分 类 号：R714.22[医药卫生—妇产科学]