剖宫产术后CSP采用MRI动态增强与经阴超声检查的影像学表现及诊断效能对比  

Comparison of imaging manifestations and diagnostic efficacy of CSP after cesarean section with MRI enhanced dynamic and transvaginal ultrasound

作　　者：高素芳 吴永华 Gao Sufang;Wu Yonghua(Department of Ultrasound,Dongguan Chashan Hospital,Dongguan 523382,China;Department of Radiology,Dongguan Chashan Hospital,Dongguan 523382,China)

机构地区：[1]东莞市茶山医院超声科 [2]东莞市茶山医院放射科,东莞523382

出　　处：《分析仪器》2022年第2期142-147,共6页Analytical Instrumentation

基　　金：东莞市科技医疗卫生研究项目(NO:201950715009764)。

摘　　要：目的:探究剖宫产术后瘢痕妊娠(CSP)采用MRI动态增强与经阴超声检查的影像学表现及诊断效能对比。方法:选择2017年1月~2020年10月期间于我院进行诊治且经病理学证实为剖宫产术后CSP的53例患者作为研究对象,对其经MRI动态增强、阴道超声检查后的结果进行比较分析。结果:53例患者中,经MRI动态增强扫描诊断为单纯孕囊型的有30例,不均质包块型有21例,诊断准确率为96.23%(51/53);经阴道超声检查诊断后为单纯孕囊型有28例,不均质包块型有19例,诊断准确率为88.68%(47/53);MRI动态增强与经阴超声检查的准确率相比无统计学意义(χ^(2)=2.163,P=0.141)。两组在瘢痕形态及与孕囊关系的诊断率比较中均无明显差异(χ^(2)=0.051,P=0.462)。53例中,胚芽、卵黄囊、原始心管搏动、孕囊瘢痕浸润的MRI动态增强扫描分别检出1例、2例、0例、3例,经阴超声检查分别检出11例、10例、8例、14例,经阴超声检查的检查率高于MRI动态增强扫描(χ^(2)=16.667,P=0.001;χ^(2)=7.619,P=0.006;χ^(2)=13.333,P=0.001;χ^(2)=16.425,P=0.001)。经病理学证实53例中有29例孕囊内出血、31例宫腔积血、13例合并绒毛及胎盘植入,MRI动态增强扫描分别检出23例、27例、12例;经阴超声检查分别检出13例、14例、5例,MRI动态增强扫描的检查率高于经阴道超声检查(χ^(2)=7.323,P=0.007;χ^(2)=12.170,P=0.001;χ^(2)=8.327,P=0.004)。结论:剖宫产术后CSP采用MRI动态增强与经阴超声检查均有良好的诊断效能,两者各有优缺点,为提高对剖宫产术后CSP患者的诊治效果,建议临床联合使用。53 patients who were diagnosed and treated in our hospital from January 2017 to October 2020and proved to be CSP after cesarean section by pathology were selected as the research objects,and the results of MRI enhanced dynamic and vaginal ultrasound examination were compared and analyzed.Among the 53 pa‐tients,30 cases were diagnosed as simple gestational sac type by MRI enhanced dynamic scan,and 21 cases were heterogeneous mass type.The diagnostic accuracy rate was 96.23%(51/53).After transvaginal ultra‐sound diagnosis,there were 28 cases of simple gestational sac type and 19 cases of heterogeneous mass type.The diagnostic accuracy rate was 88.68%(47/53).The accuracy of MRI enhancement dynamic was not statis‐tically significant compared with that of transvaginal ultrasound(χ^(2)=2.163,P=0.141).There was no signifi‐cant difference between the two groups in the comparison of the scar morphology and the diagnosis rate of the re‐lationship with the gestational sac(χ^(2)=0.051,P=0.462).Among 53 cases,the embryo,yolk sac,primitive heart tube beat,and gestational sac scar infiltration were detected by MRI enhanced dynamic in 1 case,2 cases,0 cases,and 3 cases,respectively.Transvaginal ultrasonography detected 11 cases,10 cases,8 cases,and 14cases respectively.The inspection rate of transvaginal ultrasonography was higher than that of MRI enhanced dynamic(χ^(2)=16.667,P=0.001;χ^(2)=7.619,P=0.006;χ^(2)=13.333,P=0.001;χ^(2)=16.425,P=0.001).Pathologically confirmed 53 cases,29 cases of hemorrhage in the gestational sac,31 cases of hemorrhage in the uterine cavity,13 cases of villi and placental implantation.MRI enhancement dynamic scan detected 23 cases,27 cases,and 12 cases;transvaginal ultrasonography detected 13 cases,14 cases,and 5 cases,respectively.The examination rate of MRI enhancement dynamic scan was higher than that of transvaginal ultrasonography(χ^(2)=7.323,P=0.007;χ^(2)=12.170,P=0.001;χ^(2)=8.327,P=0.004).For CSP after cesarean section,both MRI enhancement dynamic and transvaginal ultrasoun

关 键 词：剖宫产术后瘢痕妊娠 MRI动态增强 经阴超声检查 影像学表现诊断效能 

分 类 号：R445[医药卫生—影像医学与核医学] R719.8[医药卫生—诊断学]