MRI观察剖宫产切口瘢痕处早期妊娠

MRI in observation of cesarean section scar pregnancy during the first-trimester

目的利用MRI对早期剖宫产切口瘢痕处妊娠(CSP)结构进行观察。方法对29例经阴道超声拟诊为剖宫产切口瘢痕处早期妊娠的患者行MR检查,分析其切口瘢痕、妊娠囊及两者间蜕膜层的MRI特征。结果 25例切口瘢痕表现为薄壁囊状瘢痕憩室,4例仍保持非妊娠状态时的瘢痕形态。29例切口瘢痕均呈等T1短或较短T2信号。仅2例切口瘢痕与妊娠囊间无完整蜕膜层。切口瘢痕处早期妊娠分型:Ⅰa型9例、Ⅰb型2例、Ⅱa型10例、Ⅱb型4例、Ⅲ型4例。结论 MRI显示的切口瘢痕厚度与范围、妊娠囊大小对剖宫产切口瘢痕处早期妊娠的风险判断与治疗具有重要意义。MRI可为CSP的诊治提供更为直观详细的影像学依据。

Objective To observe the MRI features of cesarean scar pregnancy （CSP） during the first-trimester. Methods Totally 29 patients with cesarean scar pregnancy suspected by transvaginal ultrasound underwent MRI. MRI features of cesarean section scar （CSS）, gestational sac and decidual layer were analyzed. Results CSS in 25 patients manifested as large thin-wailed diverticulums, while in 4 patients remained the shape as non-pregnant state. CSS presented as equal T1 and iso or slightly hypo-signal intensity in T2WI of all 29 patients. There was no integrated decidual layer between CSS and gestational sac in 2 patients. Categorizations of CSP were I a in 9 patients, I b in 2 patients, II a in 10 patients, II b in 4 patients, III in 4 patients. Conclusion For risk assessment and the treatment of CSP, the thickness and range of CSC and the size of gestational sac showed by MRI could be important. MRI can provide detailed and direct evidences for diagnosis CSP.