磁共振在子宫动脉栓塞辅助治疗瘢痕妊娠中的临床应用  

Clinical Application of Magnetic Resonance Imaging in the Auxiliary Treatment of Uterine Artery Embolization for Scar Pregnancy

作　　者：李富永 Li Fuyong(Jinan People's Hospital,Jinan 271100,Shandong Province,China)

机构地区：[1]济南市人民医院,山东济南271100

出　　处：《中国社区医师》2024年第13期81-83,共3页Chinese Community Doctors

基　　金：济南市卫生健康委员会(编号:2019-1-58)。

摘　　要：目的:探讨磁共振检查在剖宫产子宫瘢痕妊娠诊断中的临床应用价值。方法:选取2021年1月-2022年1月济南市人民医院收治的疑似剖宫产子宫瘢痕妊娠患者56例作为研究对象,均进行磁共振检查,以病理诊断结果为“金标准”,计算磁共振检查诊断剖宫产子宫瘢痕妊娠的准确率、灵敏度、特异度、阳性预测值、阴性预测值,分析剖宫产子宫瘢痕妊娠磁共振检查影像特征。结果:经病理检查结果显示,56例受试者确诊剖宫产子宫瘢痕妊娠50例,32例为剖宫产子宫瘢痕妊娠1类型,18例为剖宫产子宫瘢痕妊娠2类型,6例为宫内怀孕。磁共振检查诊断剖宫产子宫瘢痕妊娠的准确率为89.29%(50/56),灵敏度为96.00%(48/50),特异度为33.33%(2/6),阳性预测值为92.31%(48/52),阴性预测值为50.00%(2/4)。有38例患者磁共振表现为单纯型妊娠囊型,子宫切口内嵌入妊娠囊下端组织,可见类圆形或椭圆形、包膜完整且边界清晰度高的长T1WI、长T2WI信号。有12例表现为混杂包块型妊娠囊,子宫切口内嵌入妊娠囊下端组织,且呈现不规则形状长T1WI、高低T2WI信号。结论:磁共振检查诊断剖宫产子宫瘢痕妊娠的准确率、灵敏度和阳性预测值均较高,有利于鉴别疾病类型,为行子宫动脉栓塞术提供依据,应用价值显著。Objective:To investigate the clinical application value of magnetic resonance in the diagnosis of uterine scar pregnancy in cesarean section.Methods:Fifty-six suspected cesarean section pregnancy patients with uterine scar admitted to Jinan People's Hospital from January 2021 to January 2022 were selected as the study objects,and all of them underwent magnetic resonance examination.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of magnetic resonance examination in the diagnosis of cicatricial pregnancy in cesarean section were calculated with pathological diagnosis as the"gold standard".The MRI imaging features of uterine scar during caesarean section were analyzed.Results:Pathological examination results showed that 50 of the 56 subjects were diagnosed with caesarean section scar pregnancy,32 were caesarean section scar pregnancy type 1,18 were caesarean section scar pregnancy type 2,and 6 were intrauterine pregnancy;the accuracy of magnetic resonance imaging in diagnosing cesarean scar pregnancy was 89.29%(50/56),sensitivity was 96.00%(48/50),specificity was 33.33%(2/6),positive predictive value was 92.31%(48/52),and negative predictive value was 50.00%(2/4);In 38 patients,magnetic resonance showed simple pregnancy sac type,and the lower end tissue of pregnancy sac was embedded in the uterine incision,long T1WI and long T2WI signals with round or oval shape,complete envelope and high boundary definition could be seen;there were 12 cases with mixed mass pregnancy sac,the lower end tissue of pregnancy sac was embedded in the uterine incision,and the irregular shape of long T1WI and high and low T2WI signals were presented.Conclusion:The accuracy,sensitivity and positive predictive value of magnetic resonance examination in the diagnosis of cicatricial pregnancy in cesarean section are high,which is beneficial to the identification of disease types and has significant application value.

关 键 词：磁共振 剖宫产子宫瘢痕妊娠 子宫动脉栓塞 诊断效能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]