经阴道彩超在子宫瘢痕处早期妊娠诊断中的应用

Clinical Application of Transvaginal Color Doppler Ultrasonography in the Diagnosis of Ectopic Pregnancy in Previous Cesarean Section Scar

目的:探讨经阴道彩色多普勒超声(彩超)在子宫瘢痕处早期妊娠诊断中的应用价值。方法:研究对象为2011年2月-2012年2月我院接诊的26例经手术或病理确诊的子宫瘢痕处早期妊娠患者,回顾性总结了26例患者的经腹及经彩超资料。结果:通过经阴道彩超的图像声像图分析,及其与手术中病理确诊对比。经阴道彩超诊断符合率(96.1%)显著高于经腹部彩超检查诊断符合率(73.1%()P<0.05)。从声像图可以将其分为三型,分别为孕囊型、不均质包快型和混合型。其声像图有各自独特的表现,主要区别在于子宫前壁的下段的表现,及周围血流信号的不同。结论:与经腹壁超声相比,经阴道彩超避免了腹部器官的影响,做到无创,快捷,方便,对子宫瘢痕处早期妊娠的诊断有较高的应用价值,值得推广应用。

Objective： To evaluate the value of transvaginal color doppler ultrasonography in the diagnosis and differential of ectopic pregnancy in previous esarean section scar. Methods： 26 cases of cesarean scar pregnancy who underwent ultrasonic examination and treated in our hospital were retrospectively studied. Results： The accuracy of transvaginal color doppler ultrasonography was higher than color doppler transabdominal ultrasound in the diagnosis of gestation cyst type （P〈0.05）. It can be divided into three types based on the ultrasonogram, which are gestation sac type, heterogeneity package fast type and mixed type. Their ultrasonograms have its＇ own characteristics especially in the lower part of the uterine wall and the different surrounding blood flow signal. Conclusion： Compared with the abdominal ultrasound, transvaginal colour doppler ultrasonography avoids the influence of abdominal organs and it is noninvasive, quick and convenient. Transvaginal color doppler ultrasonography is highly valuable in the diagnosis of ectopic pregnancy in previous cesarean section scar.