MRI及超声评估CSP子宫前壁下段瘢痕厚度情况与病理的关系  

MRI and Ultrasound Evaluation of the Relationship between the Thickness of Scar in the Lower Segment of the Anterior Wall of CSP Uterus and Pathology

作　　者：孙江连 徐晓红 SUN Jiang-lian;XU Xiao-hong(Guangdong Medical University,Zhanjiang 524003,Guangdong Province,China;Department of Ultrasound,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong Province,China)

机构地区：[1]广东医科大学,广东湛江524003 [2]广东医科大学附属医院超声科,广东湛江524001

出　　处：《中国CT和MRI杂志》2023年第9期143-146,共4页Chinese Journal of CT and MRI

基　　金：东莞市社会科技发展项目(201950715009764)。

摘　　要：目的分析MRI及超声评估瘢痕妊娠(cesarean scar pregnancy,CSP)子宫前壁下段瘢痕厚度价值,评估两种检查与宫腹腔镜手术病理结果的一致性,以期为临床选择检查方法提供参考依据。方法选取2016年5月~2022年5月本院收治的C SP患者82例,患者均于宫腹腔镜手术前进行经阴道超声及MRI检查。总结患者超声、MRI影像学表现,对比超声、MRI对患者不同分型检出率,记录不同子宫瘢痕愈合分级患者超声、MRI测量所得瘢痕厚度。对照手术送检病理检测结果,采用Pearson相关性分析超声、MRI测量瘢痕厚度与手术测量的关系,通过Kappa一致性获取超声、MRI检查结果与手术结果的K值。结果经手术检查测得三组平均子宫瘢痕厚度,差异无统计学意义(P>0.05)。82例患者中子宫瘢痕愈合分级为I级者41例,Ⅱ级者28例,Ⅲ级者13例,随着患者子宫瘢痕愈合分级的增加,超声及MRI检测瘢痕厚度均逐渐降低(P<0.05)。不同子宫瘢痕愈合分级的超声、MRI检查结果值比较无差异(P>0.05)。超声、MRI检查对单纯孕囊型检出率比较无差异(P>0.05),MRI对不均质包块型检出率为84.85%,高于超声检查(63.64%)(P<0.05)。经Pearson双变量相关性分析发现,超声、MRI测量瘢痕厚度与手术测量结果之间均为正相关(P<0.001)。手术检查发现49例患者瘢痕厚度≥3mm,<3mm者33例。经Kappa一致性检验:MRI检查与手术检查结果一致性K值=0.773,高于超声K值(0.629)。结论MRI、超声检查均可有效评估CSP子宫前壁下段瘢痕厚度,其中MRI检测结果与手术结果一致性、相关性相对更高。ObjectiveTo analyze the value of MRI and ultrasound in evaluating the thickness of scar in the lower segment of the anterior wall of the uterus in cicatricial pregnancy(CsP),and to evaluate the consistency between the two examinations and the pathological results of hysteroscopy,so as to provide a reference for clinical selection of examination methods.Methods82 patients with CsP admitted to our hospital from May 2016 to May 2022 were selected.All patients underwent transvaginal ultrasound and MRI before hysteroscopy.summarize the ultrasonic and MRI imaging manifestations of patients,compare the detection rate of ultrasonic and MRI for different types of patients,and record the scar thickness measured by ultrasonic and MRI for patients with different uterine scar healing grades.According to the pathological test results submitted by surgery,Pearson correlation analysis was used to analyze the relationship between ultrasonic,MRI measurement of scar thickness and surgical measurement,and the K value of ultrasonic,MRI and surgicalResultswas obtained through Kappa consistency.Results There was no significant difference in the average thickness of uterine scar among the three groups(P>0.05).Among the 82 patients,41 were classified as Grade I,28 as Grade II,and 13 as Grade III.With the increase of the grade of uterine scar healing,the thickness of scar detected by ultrasound and MRI decreased gradually(P<0.05).There was no difference in the ultrasonic and MRI results of different uterine scar healing grades(P>0.05).There was no difference between ultrasound and MRI in the detection rate of simple cystic type of pregnancy(P>0.05),The detection rate of MRI for heterogeneous mass was 84.85%,which was higher than that of ultrasound(63.64%)(P<0.05).Pearson bivariate correlation analysis showed that there was a positive correlation between the scar thickness measured by ultrasound and MRI and the surgical measurement results(P<0.001).The thickness of scar was≥3mm in 49 patients and<3mm in 33 patients.Kappa consistency test

关 键 词：MRI 超声 瘢痕妊娠 子宫前壁下段 

分 类 号：R445.1[医药卫生—影像医学与核医学]