超声造影在子宫破裂的临床应用初探

Primary resarch on clinical application of rupture for uterus by ultrasonic contrast

目的探讨超声造影在子宫破裂术前诊断及术后评估子宫破裂程度与子宫修复中的临床应用价值。方法应用常规超声及超声造影对5例子宫破裂患者进行检查,对比分析术前与术后声像图表现及超声造影灌注特征;并对2例术后子宫修复过程中造影灌注特征超声图像进行分析。结果 5例子宫破裂造影表现为破裂部分子宫浆膜层灌注缺失,未破裂部分子宫浆膜层造影剂灌注正常。2例手术后早期超声造影可清楚勾画出子宫破裂处肌壁因无血供显示造影剂灌注缺失,而正常子宫肌壁有血供,造影剂灌注正常,两者形成鲜明的对比。3例(例3～5)子宫修复过程中,肌壁破裂部位造影剂灌注从无到有,并逐渐恢复正常。结论超声造影对诊断子宫破裂,评估子宫破裂的程度及随访子宫修复过程有更好的敏感性和更高的准确性。

Objective To explore the clinical value of contrast-enhanced ultrasound（CEU） in diagnosing rupture of uterus before operation and evaluating the degree of rupture and its rehabilitation process after operation. Methods In this study, 5 rupture of uterus cordirmed by surgery received preoperative or postoperative routine ultrasound and CEU examination. Routine ultrasonographic characteristic and perfusing characteristic of contrast agent in rupture of uterus preoperatively and postoperatively were analyzed. And the characteristic in its rehabilitation was analyzed by follow-up. Results CEU could differentiate the ruptured uterus from healthy uterus without contrast agent infusion in ruptured serosal layer. Early postoperativeCEU had no contrast agent infusion in rupture due to lacking supply of blood. During uterus rehabilitation process, contrast agent infusion in ruptured uterus myometrium increased from nothing, and back to normal gradually. Conclusions CEUS provides high sensitivity and accuracy in diagnosing rupture of uterus and evaluating the degree of rupture and its rehabilitation process postoperatively.