经阴道彩色多普勒超声在剖宫产后子宫瘢痕妊娠中的诊断分析

Diagnostic analysis of ceasarean scar pregnancy by transvaginal color Doppler ultrasonography

目的探讨经阴道彩色多普勒超声检查对剖宫产术后子宫瘢痕妊娠的诊断意义。方法对经阴道彩色多普勒超声诊断为子宫瘢痕妊娠的34例患者进行回顾性分析。结果经阴道超声将患者分为单纯孕囊型、不均质包块型、部分位于宫颈管或宫腔型,彩色多普勒声像图有不同的表现,部分病灶区周边见丰富的血流信号,并可见五彩状血流显示,呈高频低阻型。治疗方案的选择与超声图像中孕囊或包块的类型,周围血流的情况以及子宫肌层的厚薄有关。结论经阴道彩色多普勒超声检查对子宫瘢痕妊娠的诊断是一个非常实用、方便的一线影像学检查手段,具有非常重要的临床应用价值。

Objective To discuss the diagnostic value of transvaginal color Doppler ultrasonography for ceasarean scar pregnancy（CSP）.Methods 34 cases diagnosed CSP by transvaginal ultrasound were retrospective analyzed.Results Three types of CSP were divided by the ultrasonographic figrues.type Ⅰas pure gestatonal sac,type Ⅱas mass type： type Ⅲ as cervial canal or uterous cavity partly.Color Doppler ultrasonography showed different presentation,rich bloody flow could be seen aroud the lesions,some presented as high velocity and low resisteance flow.Treatment were associated with the type of ultrasound appearance and blood flow and the thickness of lower-segment of uterus mymomerium.Conclusion Transvaginal color Doppler ultrasonography is good and convenient for the diagnosis of CSP as the first-line imaging meathod and has an important clininic value.