磁共振对剖宫产子宫瘢痕妊娠的诊断价值  

Diagnostic Value of Magnetic Resonance Imaging for Cesarean Section Uterine Scar Pregnancy

作　　者：周建良[1] 王丹雯 ZHOU Jian-liang;WANG Dan-wen(Department of Radiology,Wuzhong People's Hospital,Suzhou,Jiangsu Province,215128 China)

机构地区：[1]苏州市吴中人民医院放射科

出　　处：《中外医疗》2019年第19期177-179,共3页China & Foreign Medical Treatment

摘　　要：目的探讨磁共振诊断剖宫产瘢痕子宫的临床价值。方法以2014年1月—2018年12月为时限,方便择取该院47例经手术病理证实的剖宫产子宫瘢痕妊娠患者为研究对象,全部患者均行磁共振检查,观察影像学表现,并基于手术病理评价磁共振诊断剖宫产瘢痕妊娠的准确度。结果瘢痕妊娠磁共振主要影像学表现为子宫不同程度体积增大及内膜增厚,切口瘢痕常规序列低信号,呈不规则长T1、短T2信号影,增强后无明显强化,局部子宫肌层连续性中断,孕囊平扫T1WI等低信号,T2WI高或混杂信号,囊壁增强扫描可见环形、结节状或不均匀强化,子宫下壁肌层变薄。基于金标准,MRI确诊瘢痕妊娠45例,诊断准确率95.75%,2例误诊,误诊率4.25%。结论磁共振诊断剖宫产子宫瘢痕妊娠准确率高,能够为本病临床干预提供有价值的影像学依据,值得临床推广使用。Objective To investigate the clinical value of magnetic resonance imaging in the diagnosis of cesarean section scar uterus.Methods From January 2014 to December 2018,47 patients with cesarean section uterine scar pregnancy confirmed by surgery and pathology were convenient selected as the study subjects.All patients underwent magnetic resonance imaging and observed imaging findings.The accuracy of magnetic resonance diagnosis of cesarean section scar pregnancy based on surgical pathology evaluation.Results The main imaging findings of scar pregnancy magnetic resonance showed that the uterus increased in size and intimal thickening.The conventional sequence of incision scar was low signal,showing irregular long T1 and short T2 signal,no obvious enhancement after enhancement;local myometrium continuous interruption,gestational sac scans low signal such as T1WI,T2WI high or mixed signal,enhanced wall scan,ring,nodular or uneven enhancement,thinning of the lower uterine muscle layer.Based on the gold standard,MRI diagnosed 45 cases of scar pregnancy,the diagnostic accuracy rate was 95.75%,2 cases were misdiagnosed,and the misdiagnosis rate was 4.25%.Conclusion Magnetic resonance diagnosis of cesarean section uterine scar pregnancy has a high accuracy rate,which can provide valuable imaging evidence for clinical intervention of this disease,and is worthy of clinical promotion.

关 键 词：剖宫产 瘢痕子宫 瘢痕妊娠 磁共振检查 诊断价值 

分 类 号：R445[医药卫生—影像医学与核医学]