MRI在剖宫产术后瘢痕妊娠诊疗路径中的应用价值  

The Value of MRI in the Clinical Pathway of Cesarean Scar Pregnancy

作　　者：陈君卓 张立维[2] 胡伟卓 孙蕾[3] 高超[1] 秦海燕[1] CHEN Jun-zhuo;ZHANG Li-wei;HU Wei-zhuo;SUN Lei;GAO Chao;QIN Hai-yan(Department of Radiology,the Fourth Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang,150001,China;Department of Ultrasound,the Fourth Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang,150001,China;Department of Gynaecology and Obstetrics,the Fourth Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang,150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院影像科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第四医院超声科,黑龙江哈尔滨150001 [3]哈尔滨医科大学附属第四医院妇产科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2023年第16期3165-3168,共4页Progress in Modern Biomedicine

基　　金：哈尔滨医科大学附属第四医院特别资助项目(HYDSYTB201916)。

摘　　要：目的:探讨磁共振成像在剖宫产术后瘢痕妊娠(cesarean scar pregnancy,CSP)诊疗路径中的应用价值。方法:回顾性分析24例经手术和(或)病理证实为瘢痕妊娠的孕妇临床和影像检查资料,记录MRI上妊娠囊位置、大小、T1、T2信号强度、妊娠囊类型、妊娠囊与子宫前壁下段肌层及膀胱的关系,分析MR特征对临床诊疗路径的应用价值。结果:24例妊娠囊均位于子宫下段,为圆形或卵圆形,11例妊娠囊为单纯囊性,12例妊娠囊为混杂包块型,1例因清宫术后行MR,未见明确妊娠囊,仅见子宫下段混杂信号。10例妊娠囊附着处子宫肌厚度不可测量,余14例妊娠囊附着处子宫肌厚度约0.9~5.0 mm,平均2.5±1.1 mm。据此,CSP分型为Ⅰ型5例,Ⅱ型7例,Ⅲ型12例。结论:MRI能较好的评估CSP,在CSP诊疗路径中的应用价值较大。Objective:To explore the value of magnetic resonance imaging in the clinical pathway of cesarean scar pregnancy(cesarean scar pregnancy,CSP).Methods:The clinical and imaging data of 24 pregnant women with cesarean scar pregnancy were retrospectively analyzed.The location,size,T1 and T2 signal intensity and the type of gestational sac;relationship of the gestational sac to the lower muscular layer of the anterior uterine wall and the bladder were recorded.The value of MRI features in the clinical pathway were analyzed.Results:All 24 gestational sacs were located in the lower uterine segment and were round or ovoid.11 gestational sacs were simple cystic and 12 were mixed masses.In one case,there was no clear gestational sac on MRI after clearance,and only a mixed signal in the lower uterine segment.The thickness of the uterine muscle at the attachment of the gestational sac were not measurable in 10 cases,and the thickness of the other 14 cases were approximately 0.9~5.0 mm,with a mean of 2.5±1.1 mm.According to the thickness of the attached uterine muscle,CSP was classified as typeⅠin 5 cases,typeⅡin 7 cases,and typeⅢin 12 cases.Conclusion:MRI can better evaluate CSP.It is of greater value in the clinical pathway of CSP.

关 键 词：磁共振成像 剖宫产 瘢痕妊娠 诊疗路径 

分 类 号：R445.3[医药卫生—影像医学与核医学] R719[医药卫生—诊断学]