摘要
目的探讨MRI动态增强与多普勒超声对剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)的早期诊断价值。方法回顾性分析我院2015年6月至2017年6月收治的经病理学证实为CSP的78例患者临床及影像学资料,包括多普勒超声、MRI增强扫描,分析两种诊断方式对于CSP的早期诊断效能。结果 78例CSP患者中,MRI诊断准确率为96.15%(75/78),单纯孕囊型检出44例,不均质包块型检出31例,超声诊断准确率89.74%(70/78),单纯孕囊型检出41例,不均质包块型检出29例,二者诊断准确率相比无统计学差异(χ~2=2.445,P=0.118);病理诊断发现卵黄囊29例,胚芽18例,原始心管搏动15例,孕囊局部瘢痕浸润22例,MRI及超声检出例数分别为卵黄囊3例和24例,胚芽2例和17例,原始心管搏动0例和12例,孕囊局部瘢痕浸润5例和21例,两组诊断结果相比均具有统计学差异(χ~2=30.559、P=0.000,χ~2=25.077、P=0.000,χ~2=20.000、P=0.000,χ~2=24.068、P=0.000);病理诊断孕囊内出血43例,宫腔积血45例,合并绒毛及胎盘植入19例,MRI及超声检出例数分别为孕囊内出血35例和20例,宫腔积血40例和21例,合并绒毛及胎盘植入17例和8例,两组诊断结果相比均具有统计学差异(χ~2=11.349、P=0.001,χ~2=18.366、P=0.000,χ~2=9.471、P=0.002)。结论 MRI及超声诊断对CSP均有较高的早期诊断效能,但两种检测方式均存在各自的不足之处,进行联合应用能够更快速更准确地诊断CSP。
Objective To explore the early diagnostic value of MRI dynamic enhancement and Doppler ultrasound for cesarean scar pregnancy (CSP).Methods A retrospective analysis was performed on the clinical and imaging data of 78 patients pathologically confirmed with CSP who were admitted to the hospital from June 2015 to June 2017,including Doppler ultrasound and MRI enhanced scan.The early diagnostic efficiency of the two methods for CSP was analyzed.Results Among 78 CSP patients,diagnostic accuracy of MRI was 96.15% (75/78).There were 44 cases with simple gestational sac type,31 cases with heterogeneous mass type.The diagnostic accuracy of ultrasound was 89.74% (70/78).There were 41 cases with simple gestational sac type,29 cases with heterogeneous mass type.There was no significant difference in diagnostic accuracy between the two methods (χ~2=2.445,P=0.118).The pathological diagnosis found there were 29 cases with yolk sac,18 cases with germ,15 cases with primitive cardiac pulsation,and 22 cases with partial scar infiltration of gestational sac.MRI and ultrasound detection found that there were 3 cases and 24 cases with yolk sac,2 cases and 17 cases with germ,0 cases 12 cases and 12 cases with primitive cardiac pulsation,5 cases and 21 cases with partial scar infiltration of gestational sac,respectively.There were significant differences in diagnostic results between the two groups (χ~2=30.559,P=0.000,χ~2=25.077,P=0.000,χ~2=20.000,P=0.000,χ~2=24.068,P=0.000).The pathological diagnosis there were 43 cases with bleeding in gestational sac,45 cases with hematometra,19 cases with villus and placenta implantation.MRI and ultrasound detection found there were 35 cases and 20 cases with bleeding in gestational sac,40 cases and 21 cases with hematometra,17 cases and 8 cases villus and placenta implantation.There were significant differences in diagnostic results between the two groups (χ~2=11.349,P=0.001,χ~2=18.366,P=0.000,χ~2=9.471,P=0.002).Conclusion The early diagnostic efficiency of MRI and ultrasound is relatively high for CSP.However,both methods have their own shortcomings.Combined application can diagnose CSP more quickly and accurately.
作者
杨盛琼
石安惠
串利娟
YANG Sheng-qiong;SHI An-hui;CHUAN Li-juan(Department of Obstetrics and Gynecology,Yibin Maternal and Child Health Hospital,Yibin 644000,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2020年第9期131-133,138,共4页
Chinese Journal of CT and MRI
关键词
剖宫产术
瘢痕妊娠
磁共振成像
多普勒超声
Cesarean Section
Scar Pregnancy
Magnetic Resonance Imaging
Doppler Ultrasound
