剖宫产瘢痕妊娠MRI信号特点及临床诊治价值研究  

Characteristics of MRI Signals of Cesarean Scar Pregnancy and Its Clinical Value of Diagnosis and Treatment

作　　者：黄丽华 HUANG Li-hua(Department of Obstetrics and Gynecology,West China Guang'an Hospital of Sichuan University,Guang’an 638000,Sichuan Province,China)

机构地区：[1]四川大学华西医院广安医院妇产科,四川广安638000

出　　处：《中国CT和MRI杂志》2021年第10期127-129,共3页Chinese Journal of CT and MRI

基　　金：四川省卫生和计划生育委员会科研课题(17PJ079)。

摘　　要：目的分析剖宫产瘢痕妊娠MRI信号特点,了解其临床诊治价值。方法回顾分析,收集本院2017年1月至2019年4月收治的43例经手术病理证实为CSP患者的临床资料作为研究对象,在手术前均进行MRI检查。对患者所得MRI图像进行分析,以手术后病理结果为基准,计算MRI对CSP的诊断正确率,并了解患者MRI信号特点以及手术结果。结果MRI对CSP诊断正确率为97.67%,与手术病理结果比较无差异,与手术病理检出符合率高(P>0.05)。患者MRI表现为:患者妊娠囊黏附在患者的子宫前下壁(瘢痕处),患者妊娠囊可为类圆形或卵圆形,形态不规则,边界清晰;可见患者子宫前壁变薄,可见“3”字或“C”字征;T1WI为等低信号、混杂斑片状高信号,T2WI为混杂高信号,患者病灶周围可见环形状低信号包膜带存在。完整典型环征为有完整孕囊者,不完整或不规则环征或囊中囊为不规则混杂信号。结论CSP的MRI表现具有一定特异性征象,信号特点明显,可明确显示处孕囊于瘢痕之间关系以及病灶与周围组织关系,为临床治疗方案选择提供参考。Objective To analyze the characteristics of MRI signals of cesarean scar pregnancy to understand its clinical value of diagnosis and treatment.Methods The clinical data of 43 patients confirmed as CSP by surgery and pathology from January 2017 to April 2019 were collected as research subjects,and MRI examinations were performed before surgery.The MRI images of patients were analyzed,the postoperative pathological results were used as the benchmark to calculate the diagnostic accuracy of MRI for CSP and understand the characteristics of MRI signals and surgical results.Results The diagnostic accuracy of MRI for CSP was 97.67%,and there was no difference with the pathological surgical results,and the coincidence rate with the surgical pathological detection was high(P>0.05).The MRI manifestation of the patient showed:The patient’s pregnancy sac has adhered to the anterior inferior wall(scar)of the patient’s uterus.The patient’s pregnancy sac can be round or oval-shaped,with irregular shapes and clear boundaries.It can be seen that the anterior wall of the patient’s uterus was thinner,and"3"or"C"signs can be seen.T1WI was an equal low signal,mixed patchy high signal,T2WI was mixed high signal,and the ring-shaped low-signal envelope band can be seen around the patient’s lesion.Complete typical ring signs were those patients with complete gestational sacs,and incomplete or irregular ring signs or sacs in the sac were irregular mixed signals.Conclusion The MRI manifestations of CSP have some specific signs and characteristics of the signal that are obvious,which can clearly show the relationship between the gestational sac and the scar and the relationship between the lesion and the surrounding tissues.It can provide a reference for the selection of clinical treatment options.

关 键 词：剖宫产 瘢痕妊娠 MRI 信号特点 临床诊治 

分 类 号：R714.22[医药卫生—妇产科学] R445.2[医药卫生—临床医学]