磁共振成像在早期剖宫产瘢痕妊娠和不全流产瘢痕停滞的诊断价值  

Diagnostic value of MRI in early cesarean scar pregnancy and incomplete abortion scar stasis

作　　者：张玉 雷夏峰 鲁涛[3] 刘艳玲[1] Zhang Yu;Lei Xiafeng;Lu Tao;LiuYanling(Imaging Center,Anyang District Hospital,Henan 455000,China;不详)

机构地区：[1]河南省濮阳市安阳地区医院影像科,455000 [2]河南省安阳市灯塔医院影像科 [3]河南省安阳市妇幼保健院影像科

出　　处：《实用医学影像杂志》2024年第5期347-350,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨早期剖宫产瘢痕妊娠(CSP)和不全流产瘢痕停滞的磁共振成像(MRI)表现及两者之间的鉴别特征。方法收集本院和安阳市妇幼保健院2017年3月至2023年11月经临床及病理证实的53例早期CSP和16例不全流产瘢痕停滞患者的临床资料。用χ^(2)检验对比分析2组MRI征象之间差异是否存在统计学意义。结果CSP的MRI表现:妊娠囊形态规则、饱满48例,囊内信号均匀,囊壁厚薄较一致;35例患者妊娠囊可见尖角状或结节状凸起向瘢痕肌层延伸,14例患者妊娠囊与瘢痕分界模糊,瘢痕处肌层连续性中断;宫体肌层局部增厚突出8例;宫腔积血37例。不全流产瘢痕停滞的MRI表现:13例患者妊娠囊形态不规则,部分囊壁皱缩或塌陷,形态饱满3例;14例患者妊娠囊与瘢痕分界清晰,1例见尖角状凸起,1例分界模糊,肌层连续性中断;宫体肌层局部增厚突出14例;宫腔积血13例。妊娠囊的形态、妊娠囊与瘢痕间的尖角状或结节状凸起及宫体肌层局部明显增厚突出,2组之间差异具有统计学意义(P<0.01)。结论早期CSP和不全流产瘢痕停滞的MRI表现具有一定特征性,妊娠囊的形态、妊娠囊与瘢痕间的尖角状或结节状凸起及宫体肌层局部明显增厚突出对CSP和不全流产瘢痕停滞的诊断和两者之间的鉴别具有重要价值。Objective To explore the MRI features of early Cesarean scar pregnancy(CSP)and incomplete abortion scar stagnation and their differential features.Methods Clinical data of 53 cases with early cesarean scar pregnancy and 16 cases with incomplete abortion scar stagnation confirmed by clinical and pathological from our hospital and Maternal and Child Health Care Hospital in Anyang from March 2017 to April 2022 were collected.Theχ^(2) test was used to compare and analyze whether there was statistical significance between the two MRI signs.Results MRI findings of CSP:the shape of the gestational scar of 48 cases was regular and full,the signals of SAC were uniform and the walls were consistent.In 35 cases,the pregnancy bursa extended to the scar,and in 14 cases,the dividing line between the pregnancy bursa and the scar was broken.There were 8 cases with local thickening and protrusion of myometrium,and 37 cases with hemocoel in the uterine cavity.MRI findings of incomplete abortion scar stagnation:in 13 cases,the shape of the gestational scar was irregular,part of the wall shrank or collapsed,and the SAC was full in 3 cases.In 14 cases,the dividing line between the gestational sac and the scar was clear,1 case had a sharp horn-shaped projection,and 1 case had a dividing wall and the muscle continuity was interrupted.There were 14 cases with local thickening and protrusion of myometrium and 13 cases with hematocele in the uterine cavity.There were significant differences(P<0.01)between the two groups in the shape of the gestational sac,the sharp angle or nodular protuberance between the gestational sac and scar,and the local obvious thickening of myometrium.Conclusion MRI findings of early CSP and incomplete abortion scar stagnation have certain characteristics,the shape of gestational sac,the sharp angle or nodular protuberance between gestational sac and scar,and the local obvious thickening of myometrium are of great value in the diagnosis of early CSP and incomplete abortion scar stagnation and the differentiation

关 键 词：磁共振成像 剖宫产术 不全流产瘢痕停滞 

分 类 号：R714.22[医药卫生—妇产科学] R445.2[医药卫生—临床医学]