超声超微血流成像技术评估早孕期子宫疤痕妊娠相关风险的研究  

Study on the risk of cesarean scar pregnancy in early pregnancy by ultrasound superb microvascular imaging

作　　者：黄春荣 黄松带 李彩萍 王晓平 刘阳 高坤华 HUANG Chun-rong;HUANG Song-dai;LI Cai-ping(Department of Diagnostic Ultrasound,Huangjiang Hospital,Dongguan 523750,China)

机构地区：[1]黄江医院超声科,523750

出　　处：《中国实用医药》2021年第10期7-10,共4页China Practical Medicine

基　　金：东莞市社会科技发展项目(项目编号:201850715041618)。

摘　　要：目的探讨超声超微血流成像技术(SMI)评估早孕期子宫疤痕妊娠(CSP)相关风险的价值。方法 59例早孕期CSP患者,结合经腹和经阴道超声检查。记录观察超声分型、超声SMI评分以及治疗情况,分析超声分型与SMI评分间的关系以及CSP出现大出血风险的影响因素。结果 59例CSP患者经手术等诊疗方法证实:超声正确诊断58例,漏诊1例。超声分型:Ⅰ型32例,Ⅱ型14例,Ⅲ型12例,其中超声诊断分型错误2例(Ⅱ型误诊为Ⅰ型)。SMI评分:0分0例, 1分32例, 2分8例, 3分18例。不同分型的超声SMI评分比较,差异具有统计学意义(χ^(2)=23.60, P<0.05)。CSP出现大出血风险的影响因素分析显示,年龄(X1)、剖宫产次数(X2)、超声SMI评分(X3)对治疗过程中大出血风险预测有较大的相关性。回归方程:Y=392.844-21.358 X1+183.603 X2+178.535 X3。结论超声SMI评分作为一种半定量方法评估早孕期CSP相关风险具有重要临床价值,同时能协助临床选择更加合适的治疗方案。Objective To discuss the value of cesarean scar pregnancy(CSP) in early pregnancy by ultrasound superb microvascular imaging(SMI). Methods A total of 59 CSP patients all received transabdominal and transvaginal ultrasound examinations. The ultrasound classification, ultrasound SMI score and treatment status were recorded and observed, and the correlation between ultrasound classification and SMI score, and the influencing factors of the risk of major bleeding in CSP were analyzed. Results 59 CSP patients were confirmed by surgery: 58 cases were correctly diagnosed by ultrasound and 1 case was missed. Ultrasound classification: 32 cases of type Ⅰ, 14 cases of type Ⅱ, 12 cases of type Ⅲ, of which 2 cases were incorrectly diagnosed by ultrasound(type Ⅱ was misdiagnosed as type Ⅰ). SMI score: 0 point in 0 case, 1 point in 32 cases, 2 points in 8 cases, 3 points in 18 cases. There was statistically significant difference in ultrasound SMI score of patients with different classifications(χ^(2)=23.60, P<0.05). Analysis of factors affecting the risk of major bleeding in CSP showed that age(X1), number of cesarean sections(X2), and ultrasound SMI score(X3) had a greater correlation with the risk of major bleeding during treatment. Regression equation: Y=392.844-21.358 X1+183.603 X2+178.535 X3. Conclusion Ultrasound SMI score as a semi-quantitative method has important clinical value in assessing the risk of cesarean scar pregnancy in early pregnancy, and can help the clinical selection of more appropriate treatment options.

关 键 词：超微血流成像技术 早孕期子宫疤痕妊娠 分型 评分 相关风险 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]