磁共振对剖宫产瘢痕妊娠的诊断及临床价值  

Diagnosis and clinical value of magnetic resonance imaging in scar pregnancy

作　　者：何慧[1] 顾晗 何玲[1] 周长武[1] HE Hui;GU Han;HE Ling;ZHOU Changwu(Department of Radiology,the Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学附属医院放射科,扬州225000

出　　处：《磁共振成像》2020年第3期207-210,共4页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探讨研究3.0 T磁共振成像(magnetic resonance imaging,MRI)对于剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)的影像学特征及其对临床的应用价值。材料与方法回顾性收集2013年7月至2019年4月就诊于扬州大学附属医院并诊断为CSP共38例患者的基本临床资料,利用扫描仪器GE 750 W获取所有病例盆腔MRI图像,分析病灶特征、生长方式、有无血管流空、孕囊与瘢痕相交长度及孕囊距子宫浆膜面的距离及收集临床相关治疗方案。结果在MR上孕囊可表现为单纯囊性及混杂包块型,混杂包块型较单纯囊性妊娠囊有更大的最大径、孕囊体积以及与子宫瘢痕相交长度,且差异具有统计学差异(P<0.05);从孕囊的生长方式上可分为外生型及内生型,外生型较内生型孕囊血供更为丰富,距子宫浆膜面距离更薄,且差异具有统计学意义(P<0.05);38例患者进行相关治疗,在1~3个月内血人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)恢复至正常值,预后良好。结论磁共振对CSP患者可进行全面评估,充分了解病灶的基本特征及其与周围组织关系,为定制个性化临床治疗方案提供依据。Objective: To investigate the features and clinical value of cesarean scar pregnancy(CSP) using 3.0 T magnetic resonance imaging(MRI). Materials and Methods: The basic clinical information of 38 patients with CSP diagnosed at the affiliated hospital of Yangzhou university from July 2013 to April 2019 was collected retrospectively. The pelvis of all cases was imaged on a 3.0 T GE 750 W scanner. The characteristics and growth patterns of lesions, the presence or absence of vascular emptying, the length of the gestational sac and scar intersection, the distance from gestational sac to the uterine serosa surface, and relevant treatment options were evaluated. Results: The gestational sac can be characterized by simple cystic and mixed masses on MR images, and the mixed masses had significantly larger maximum diameter, gestational sac volume and length of uterine scar than the simple cystic gestational sacs(P<0.05). The gestational sac could be divided into exogenous and endogenous according to the growth pattern, exogenous type had more blood supply and shorter distance from the uterine serosa than endogenous gestational sac(P<0.05). All 38 patients with CSP had good prognosis after undergoing related treatment, and the blood HCG returned to normal value within 1-3 months. Conclusions: Magnetic resonance imaging can comprehensively investigate the characteristics of the lesion and its relationship with surrounding tissues for the patients with CSP, and provide a basis for individualized clinical treatment.

关 键 词：剖宫产瘢痕妊娠 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]