静脉超声造影在疤痕处妊娠诊断中的应用价值  

The Value of Intravenous Contrast-enhanced Ultrasonography in the Diagnosis of Cesarean Scar Pregnancy

作　　者：马菊香[1] 马永红[1] 高姗姗 方颖 朱珉[1] 段振玲[1] MA Ju-xiang;MA Yong-hong;GAO Shan-shan;FANG Yin;ZHU Min;DUAN Zhen-ling(Dept.of Obstetrics and Gynecology,The first Affiliated Hospital of KunmingMedical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院妇产科,云南昆明650032

出　　处：《昆明医科大学学报》2020年第10期62-66,共5页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(2018JS200)。

摘　　要：目的探讨静脉超声造影在剖宫产术后疤痕处妊娠患者诊断中的运用价值及成像特点。方法选择2015年12月至2019年12月昆明医科大学第一附属医院妇产科收治的62例常规超声检查疑为疤痕妊娠患者为研究对象,行静脉超声造影检查,分析病灶成像特点,单纯常规超声检查与常规超声联合静脉超声造影检查的结果与术后病理金标准相对照,比较两者诊断率。结果 (1)常规超声检查与金标准的诊断符合率为72.5%,常规超声联合静脉超声造影检查与金标准的诊断符合率为100%;(2)剖宫产疤痕妊娠组的静脉造影开始时间及达峰时间(TP)均早于难免流产组,差异有统计学意义(P<0.05),峰值强度(PI)高于难免流产组,差异有统计学意义(P<0.05)。结论(1)常规超声联合静脉超声造影检查较单纯常规超声检查能够明显提高剖宫产术后疤痕妊娠诊断率,为临床精准治疗提供依据;(2)静脉超声造影对于疤痕处妊娠诊断有特征性表现,有助于确诊该病。Objective To investigate the imaging characteristics and application value of intravenous contrast-enhanced ultrasonography(CEUS) in the diagnosis of pregnancy with scar after cesarean section. Methods From December 2015 to December 2019, 62 patients suspected of being scar pregnancy by conventional ultrasound in the 1 st Affiliated Hospital of Kunming Medical University were selected as the research object. The intravenous CEUS was conducted. Compared with postoperative pathologic results, the diagnostic rates of conventional ultrasound, conventional ultrasound combined with intravenous CEUS were compared. Results(1)The diagnostic coincidence rate between conventional ultrasound examination and postoperative pathology was 72.5%,and that between conventional ultrasound combined with CEUS examination and gold standard was 100%.(2)The contrast initiation time and time to peak(PT) of cesarean section scar pregnancy group were earlier than those of the inevitable abortion group, with statistically significant differences(P < 0.05), and the peak intensity(PI)was higher than that of the inevitable abortion group, with statistically significant differences(P < 0.05).Conclusion(1)Compared with vaginal ultrasonography alone, conventional ultrasound combined with CEUS can significantly improve the diagnosis rate of scar pregnancy after the cesarean section and provide the basis for clinical precision treatment;2.Intravenous CEUS has characteristic features for the diagnosis of pregnancy in scar, which is helpful for the diagnosis of this disease.

关 键 词：静脉超声造影 疤痕妊娠 应用价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]