经阴道三维超声结合高清血流模式对于子宫瘢痕憩室的诊断价值  

The diagnostic value of transvaginal three-dimensional ultrasound combined with high-definition blood flow pattern for uterine scar diverticulum

作　　者：陈丽婷 金晓可 章芳芳 CHEN Liting;JIN Xiaoke;ZHANG Fangfang(Department of Ultrasound,Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Lishui,Zhejiang 323000,China;Department of Obstetrics and Gynecology,Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Lishui,Zhejiang 323000,China)

机构地区：[1]浙江中医药大学附属丽水中医院超声科,浙江丽水323000 [2]浙江中医药大学附属丽水中医院妇产科,浙江丽水323000

出　　处：《中国优生与遗传杂志》2021年第8期1167-1170,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的研究瘢痕憩室形成的影响因素及经阴道三维超声结合高清血流模式对于子宫瘢痕憩室的诊断价值。方法选择2017年3月至2020年3月,以120例在本院妇科就诊的剖宫产史患者为研究对象,将经阴道超声技术将病例分为瘢痕憩室组和对照组,并分析其临床情况,通过经阴道三维超声结合高清血流流动模式分析子宫瘢痕憩室的形态和周围肌层血流参数、瘢痕憩室的大小及其影响因素,子宫位置和剖宫产次数之间的关系。结果剖宫产术后瘢痕憩室患者的剖宫产次数和月经天数极显著高于对照组患者(P<0.01),且子宫位置多为后移子宫,两组年龄和子宫内膜厚度没有显著差异(P>0.05),而在瘢痕憩室患者中,后移子宫瘢痕憩室的深度、宽度和高度显著大于前屈子宫(P<0.05),而瘢痕憩室处肌层厚度则显著更薄(P<0.05);此外,与对照组相比,瘢痕憩室周围肌肉层中血流主要是Ⅱ级和Ⅲ级血流,且VI值、FI值和VFI值极显著增高(P<0.01);而相较于传统二维超声,经阴道三维彩色多普勒超声结合高清血流模式,对瘢痕憩室的敏感性为95.0%,明显高于经阴道二维超声检查(85.0%),而误诊率(3.3%vs11.7%)则明显降低。结论经阴道三维超声结合高清血流模式可以有效识别和诊断瘢痕憩室。Objective To study the influenced factors of scar diverticulum formation and the diagnostic value of transvaginal three-dimensional ultrasound combined with high-definition blood flow pattern for uterine scar diverticulum.Methods From March 2017 to March 2020,120 patients with a history of cesarean section were selected as the research object in the gynecology department of our hospital.The cases were divided into scar diverticulum group and control group by transvaginal ultrasound technology.The clinical analysis was performed,and the morphology of uterine scar diverticulum and the blood flow parameters of the surrounding muscle layer was analyzed by transvaginal three-dimensional ultrasound combined with high-definition blood flow mode.The size of scar diverticulum and its influenced factors,the relationship between uterine position and the number of cesarean sections were analyzed.Results The number of cesarean sections and the number of menstrual days in patients with scar diverticulum after cesarean section were significantly higher than those in the control group(P<0.01),and the uterine position was mostly posterior to the uterus.There was no significant difference in age and endometrial thickness between the two groups(P>0.05).In patients with scar diverticulum,the depth,width and height of the scar diverticulum in the posterior uterus were significantly larger than that of the flexion uterus(P<0.05),while the thickness of the muscle layer at the scar diverticulum is significantly thinner(P<0.05).Compared with the control group,the blood flow in the muscle layer around the scar diverticulum was mainly gradeⅡand gradeⅢblood flow,and the VI value,FI value and VFI value were significantly higher(P<0.01).And compared with traditional two-dimensional ultrasound,transvaginal Three-dimensional color Doppler ultrasound combined with high-definition blood flow patterns had a sensitivity of 95.0%for scar diverticulum,which was significantly higher than that of transvaginal two-dimensional ultrasound(85.0%,P<0.05

关 键 词：瘢痕憩室 经阴道超声 血流速度 血流搏动指数 

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