DWI及MRI增强在早期瘢痕妊娠中的临床应用  

Clinical Application of DWI and MRI Enhancement in Early Cesarean Scar Pregnancy

作　　者：张卫民[1] 马德云[2] 钟升院 陈洪祁 庾汉华 李少怀 程启明 ZHANG Wei-min;MA De-yun;ZHONG Sheng-yuan(Department of Radiology,Huangjiang Hospital of Dongguan City,Dongguan 523750,Guangdong Province,China)

机构地区：[1]广东省东莞市黄江医院放射科,广东东莞523750 [2]广东省东莞市黄江医院妇产科,广东东莞523750 [3]广东省东莞市人民医院放射科,广东东莞523059

出　　处：《中国CT和MRI杂志》2020年第7期115-117,共3页Chinese Journal of CT and MRI

基　　金：广东省自然科学基金项目(编号:2017A030313120)。

摘　　要：目的探讨扩散加权成像(DWI)及磁共振成像增强(DCE)在早期瘢痕妊娠(CSP)中的临床应用价值。方法选取2017年9月~2018年9月间收治的98例拟诊为CSP患者作为研究对象,所有患者均经磁共振成像(MRI)和超声检查。比较DWI联合MRI增强、超声诊断CSP的效能,绘制ROC曲线分析两者诊断效能差异。结果①超声诊断CSP灵敏度低于DWI联合MRI增强(P<0.05),超声诊断CSP准确率低于DWI联合MRI增强(P<0.05);②囊状孕囊:T1WI序列上孕囊呈圆形或类圆形低信号影,边界不清;T2WI序列上孕囊呈囊状高信号,边界清晰;增强MRI显示孕囊壁可见环形薄壁强化和囊内不同程度的强化影,DWI序列呈低信号,内部信号均匀,有7例DWI表现为高信号灶。包块型孕囊:T1WI序列呈等信号中夹杂局限性高信号;T2WI序列呈等、高混杂信号,DWI序列呈混杂信号;③ROC曲线显示超声、MRI诊断CSP AUC分为为0.795、0.885,MRI更高(P<0.05)。结论 MRI经DWI及MRI增强在早期CSP中的诊断效能高于超声,有一定临床应用价值。Objective To explore the clinical application value of diffusion-weighted imaging(DWI) and dynamic-contrast enhanced scan(DCE) in early cesarean scar pregnancy(CSP). Methods 98 patients with possible CSP who were admitted between September 2017 and September 2018 were selected for the study. All patients were given magnetic resonance imaging(MRI) and ultrasound. The efficacies of DWI combined with MRI enhancement and ultrasound in the diagnosis of CSP were compared, and ROC curve analysis was drawn to analyze the diagnostic efficacy of the two. Results The sensitivity of ultrasound diagnosis of CSP was lower than that of DWI combined with MRI(P<0.05), and the accuracy rate of ultrasound diagnosis of CSP was lower than that of DWI combined with MRI(P<0.05). As for cystic gestational sac, gestational sac in T1WI sequence showed round or quasi-circular low signal with unclear boundary, and gestational sac in T2WI sequence showed cystic high signal with clear boundary. Enhanced MRI showed annular thin-wall enhancement in gestational sac wall and different degrees of enhancement shadow in the sac, and DWI sequence showed low signal and uniform internal signal, and 7 cases of DWI showed high signal focus. As for mass-type gestational sac, T1WI sequence showed mixed local high signal in the equal signal, and T2WI sequence showed equal and high mixed signal, and DWI sequence showed mixed signal. ROC curve showed the AUC values of ultrasound and MRI in the diagnosis of CSP were 0.795 and 0.885, and the value of MRI was higher(P<0.05). Conclusion DWI and MRI enhancement through MRI has higher diagnostic efficacy than ultrasound in early CSP, and it has certain clinical application value.

关 键 词：早期瘢痕妊娠 磁共振成像 扩散加权成像 动态增强扫描 

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]