经阴道三维超声检测剖宫产后子宫切口憩室的声像图特征及其诊断价值  

Ultrasonographic characteristics of uterine incision diverticulum inspected by transvaginal three-dimensional ultrasound after cesarean section and its diagnostic value

作　　者：高珍[1] 王义[1] 王珍荣[1] GAO Zhen;WANG Yi;WANG Zhenrong(People's Hospital of Macheng,Hubei Province,438300)

机构地区：[1]湖北省麻城市人民医院,438300

出　　处：《中国计划生育学杂志》2020年第10期1643-1645,F0003,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨经阴道三维超声检测剖宫产后子宫切口憩室的声像图特征及其诊断价值。方法:回顾性收集2016年10月-2018年12月本院二维经腹彩超检查疑似剖宫产后子宫切口憩室患者350例,采用经阴道三维超声检查测量子宫切口憩室长度、宽度、深度、切口肌层厚度,观察憩室形态(裂缝状液性暗区、囊状液性暗区、楔形液性暗区)等声像图特征。根据是否存在临床症状分为症状组和无症状组。观察组间声像图特征差异。以宫腔镜检查为准,分析经阴道三维超声诊断子宫切口憩室的灵敏度和特异度。结果:经阴道三维超声检查符合子宫切口憩室246例,有临床症状组103例,无症状组143例,症状组患者子宫切口憩室长度(8.92±2.35mm)、宽度(10.95±3.67mm)、深度(5.87±1.79mm)、切口肌层厚度(3.25±1.03mm)均大于无症状组(P<0.05),无症状组以裂缝状液性暗区为主(47.6%),症状组以囊状、楔形液性暗区为主(93.2%)(P<0.05)。经阴道三维超声诊断剖宫产后子宫切口憩室的ROC曲线下面积(AUC)为0.786(95%CI:0.685~0.887,P=0.000),灵敏度为77.1%,特异度为80.0%。结论:经阴道三维超声诊断剖宫产后子宫切口憩室具有较高临床价值。Objective: To investigate the ultrasonographic characteristics of uterine incision diverticulum(UID) inspected by transvaginal three-dimensional ultrasound(TTDU) after cesarean section, and to analyze its diagnostic value. Methods: The data of 350 women with suspected uterine incision diverticulum from October 2016 to December 2018 were collected retrospectively. The length, width, depth, thickness of incision muscle layer, shape of diverticulum(fissure liquid dark area, cystic liquid dark area, wedge liquid dark area) and other ultrasonographic features of UID of these women were observed by TTDU. And these women were divided in to group A and B according to the existence of clinical symptoms. The difference of sonographic features of women was observed between the two groups. Based on the result of diagnosd by hysteroscopy, the sensitivity and specificity of TTDU were analyzed. Results: There were 246 women with UID by TTDU, which included 103 women with clinical symptoms in group A and 143 women without clinical symptoms in group B. The length, width, depth, and incision myome thickness of UID of women in group A were 8.92±2.35 mm, 10.95±3.67 mm, 5.87±1.79 mm, and 3.25±1.03 mm, respectively, which were significant higher than those of women in group B(P<0.05). In group A, the rate of fissure-like dark areas(47.6%) of women was the main, but in group B, the rate of cystic and wedge-shaped liquid dark areas(93.20%) was the main(P<0.05). The area under ROC curve(AUC) of UID by TTDU was 0.786(95% CI: 0.685-0.887, P=0.000), which’s sensitivity and specificity were 77.1% and 80.0%. Conclusion: TTDU used for diagnosing UID after cesarean section has high clinical value.

关 键 词：剖宫产 子宫切口憩室 经阴道三维超声 声像图特征 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R719.8[医药卫生—诊断学]