无创检查技术在剖宫产瘢痕部位妊娠早期诊断中的应用性比较  

Comparison of application of non-invasive examination technique in diagnosing a first-trimester of cesarean scar pregnancy

作　　者：刘燕[1] 夏进东 许凡勇 Liu Yan;Xia Jindong;Xu Fanyong(Songjiang District Central Hospital,Clinical Medical School of Nanjing Medical University,Shanghai 201600,China)

机构地区：[1]南京医科大学附属松江区中心医院,上海201600

出　　处：《中国产前诊断杂志（电子版）》2020年第3期43-48,共6页Chinese Journal of Prenatal Diagnosis(Electronic Version)

摘　　要：目的分析无创检查技术彩色多普勒超声与磁共振成像(magnetic resonance imaging,MRI)诊断早期剖宫产瘢痕部位妊娠(cesarean scar pregnancy,CSP)的影像学特征,比较2种无创检查技术诊断CSP的临床价值。方法回顾性分析南京医科大学附属松江区中心医院经手术及病理证实的37例具有完整临床资料的早期CSP病例,37例均行经阴道或补充经腹彩色多普勒超声检查及增强磁共振检查,分析早期CSP影像学表现,对比2种检查方法诊断早期CSP的准确率。结果本组37例早期CSP患者,超声正确诊断31例,诊断正确率83.4%。超声图像分3型,孕囊型26例、不均质团块型9例、蜂窝型2例。增强MRI检查正确诊断35例,诊断正确率94.6%,差异无统计学意义(P>0.05)。结论彩色多普勒超声和MRI是诊断CSP的有效方法,彩色多普勒超声简便、患者接受度高,是CSP诊断的首选检查方法;对其难以确诊的病例,特别是不均质团块型和蜂窝型CSP,可选择MRI进一步检查。Objective Analysis of non-invasive technique of color Doppler ultrasound and magnetic resonance imaging(MRI)in diagnosis of cesarean scar pregnancy(CSP),comparing the clinical value of the two noninvasive examination technology in the diagnosis of CSP.Methods Thirty-seven cases of caesarean scar pregnancy with integrated clinical data confirmed by surgery and pathology were retrospectively analyzed,these thirty-seven cases all diagnosed by transvaginal color Doppler sonography(TVS)or abdominal ultrasound supplement and gadolinium-enhanced MRI,analysis of CSP imaging findings,compare the accuracy rate of the two methods.Results Of the thirty-seven cases,thirty-one cases were correctly diagnosed by ultrasound,diagnostic accuracy was 83.4%.There were three types of sonographic findings:gestational sac type for twenty-six cases,heterogeneous mass type for 9 cases,honeycomb type for two case.Thirty-five cases were correctly diagnosed by MRI,diagnostic accuracy was 94.6%(P>0.05),there was no statistically significant difference.Conclusion Color Doppler ultrasound and MRI are effective methods for diagnosis of cesarean scar pregnancy,Color doppler ultrasound is practical and can be highly accepted among patients,it is the first choice for the CSP diagnosis,for cases which were hardly to be diagnosed,especially heterogeneous mass type and honeycomb type CSP,can choose MRI as the further examination.

关 键 词：瘢痕妊娠 剖宫产 超声 磁共振成像 

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]