超声弹性成像技术评估先前剖宫产妇女的子宫瘢痕弹性程度  

Evaluation of uterine scar elasticity in women undergoing previous cesarean section by ultrasonic elastography

作　　者：钟璐男 周飞宇 胡菊梅 ZHONG Lunan;ZHOU Feiyu;HU Jumei(Jinhua Municipal Central Hospital,Jinhua,Zhejiang 321300,China)

机构地区：[1]金华市中心医院,浙江金华321300

出　　处：《中国优生与遗传杂志》2021年第10期1480-1483,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的以子宫周围完整肌层为参照,应用弹性成像技术评价定量评价剖宫产(CS)瘢痕弹性程度,并探讨剖宫产瘢痕弹性程度是否受既往剖宫产临床特征的影响。方法将2017年1月至2020年12月于本院超声科就诊的怀孕37周的剖宫产史子宫瘢痕患者纳入研究,经阴道超声选择两个感兴趣区(ROI):子宫瘢痕(区1)和周围子宫肌层(区2),计算每个ROI的应变指数(SI),并将应变比(SR)定义为区1SI/区2SI,主要结果是比较有无阴道分娩史、产程中CS、产后缝合类型或产后发热妇女的SR,次要结果是评估SR与母体、新生儿和分娩特征的相关性。结果共纳入86名女性,平均SR为1.91±0.63,表明子宫瘢痕较周围子宫肌层僵硬,根据既往有经阴道分娩史、CS史、产后缝合方式或产后发热分组后,SR差异无统计学意义(P>0.05),且应变比与母体特征、分娩和新生儿结局无关。结论应用弹性成像技术评价子宫瘢痕硬度是可行的,子宫瘢痕的硬度高于周围子宫肌层,但与母体特征和分娩特征无关。Objective The purpose of this study was to evaluate the degree of elasticity of cesarean scar quantitatively by elastography with reference to the intact myometrium around the uterus,and to explore whether the degree of scar elastici ty of cesarean section is affected by the clinical characteristics of previous cesarean section.Methods Patients with uterine scar with cesarean section(CS)history of cesarean section at 37 weeks of pregnancy who were treated in the ultrasound department of our hospital from January 2017 to December 2020 were included in the study.Two regions of interest,region of interest(ROI):uterine scar(area 1)and surrounding uterine myometrium(area 2),were selected by transvaginal ultrasound,and the strain index(SI),of each ROI was calculated and the strain ratio(SR)was defined as regional 1SI/region 2SI.The main outcome was to compare the SR,of women with or without history of vaginal delivery,CS during labor,type of postpartum suture or postpartum fever.The secondary result was to assess the correlation between SR and maternal,neonatal and delivery characteristics.Results A total of 86 women were enrolled,the average SR was 1.91±0.63,indicating that the uterine scar was stiffer than the surrounding myometrium.According to the previous history of vaginal delivery,CS history,postpartum suture or postpartum fever,there was no significant difference in SR,and the strain rate was not related to maternal characteristi cs,delivery and neonatal outcome.Conclusion It is feasible to evaluate the hardness of uterine scar by elastography.The hardness of uterine scar is higher than that of surrounding myometrium,but it has nothing to do with maternal characteristics and d elivery characteristics.

关 键 词：子宫瘢痕 剖宫产 应变指数 超声 弹性成像 

分 类 号：R719.8[医药卫生—妇产科学]