剖宫产术后疤痕妊娠MRI影像特征及其对治疗方案的指导价值  

MRI Findings of Cesarean Scar Pregnancy and Their Guiding Value for the Treatment

作　　者：李瑛 罗军 LI Ying LUO Jun(Xinyang Central Hospital,Xinyang 464000,Henan Province,China)

机构地区：[1]河南省信阳市中心医院,河南信阳464000

出　　处：《中国CT和MRI杂志》2019年第2期78-80,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨剖宫产术后疤痕妊娠产妇的MRI影像学特征及其对治疗方案的指导意义。方法回顾分析经手术证实为子宫瘢痕妊娠32例患者临床资料,分析其MRI影像学成像特点,并根据成像特点分析其手术治疗特点。结果 (1)32例患者中,MRI图像的孕囊清晰可见,子宫峡部可见稍长T1、稍短T2信号影(剖宫产瘢痕),强化不明显;(2)妊娠囊包膜完整者,MRI上表现为长T1或稍长T1、长T2环形信号影,囊内容物表现为长T1长T2信号,T2WI图像上较包膜信号强;妊娠囊包膜不完整者,其图像主要表现为稍长T1信号,稍长、等或稍短T2信号;(3)共8例患者孕囊完全植入子宫肌层,在子宫前呈"C"形、"反3"形,24例患者的孕囊呈宫腔内生长趋势,子宫肌层浸润,植入子宫壁较浅,与肌层有明显分界;(4)患者根据妊娠囊植入情况及子宫壁最薄处情况,主要采取腹腔镜下CSP电切术治疗。结论 CSP患者的MRI的影像学表现具有一定特异性,可为CSP患者治疗方案提供参考。Objective To explore the MRI findings of cesarean scar pregnancy(CSP)and their guiding significance for the treatment.Methods The clinical data of 32 patients with CSP confirmed by operation were analyzed retrospectively.The MRI findings were analyzed,and the characteristics of operation were analyzed according to the imaging findings.Results(1)MRI images of the 32 cases showed clear gestation sac,and the uterine isthmus showed slightly long T1 and slightly short T2 signal(caesarean scar),with unobvious enhancement.(2)MRI of pregnant women with intact gestation sac showed T1 or slightly longer T1 and long T2 annular signal.The contents of the sac showed long T1 and long T2 signal with strong capsule signal on T2 WI.Images of those with incomplete gestation sac showed slightly longer T1 signal,slightly longer,equal or slightly shorter T2 signal.(3)There were 8 cases with gestation sac complete implanted in uterine myometrium.The uterus was C-shaped or anti-3 shaped.The gestation sacs of 24 cases showed intrauterine growth trend,the myometrium was involved and the implanted uterine wall was shallow,with clear boundary with the muscle layer.(4)Patients were treated by laparoscopic CSP electrocision according to the condition of the gestation sac implantation and the thinnest wall of the uterus.Conclusion MRI findings of patients with CSP are specific,which can provide reference for the treatment of CSP.

关 键 词：剖宫产 子宫瘢痕妊娠 MRI 指导价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]