超声造影与彩色多普勒超声诊断剖宫产切口瘢痕妊娠的对比研究

Comparative Study on the Diagnosis of Cesarean Scar Pregnancy(CSP) by Contrast Enhanced Ultrasound(CEUS) with Color Doppler Flow Imaging(CDFI)

目的探讨超声造影与彩色多普勒超声在诊断剖宫产术后切口疤痕妊娠中的应用价值。方法对二维超声显示孕囊位于子宫峡部的44例患者进行超声造影与彩色多普勒超声检查,对比分析超声造影与彩色多普勒超声诊断疤痕妊娠的准确性。结果 44例患者,手术证实40例为瘢痕妊娠,4例为宫内孕难免流产。超声造影准确诊断瘢痕妊娠39例,漏诊1例,瘢痕妊娠的超声造影表现可分为孕囊型与不均质团块型。孕囊型表现为"面包圈样"增强,不均质团块型表现为不均匀增强。超声造影诊断瘢痕妊娠的敏感性、特异性和准确性分别为97.5%、75.0%和95.3%。彩色多普勒超声准确诊断切口妊娠33例,漏诊7例,彩色多普勒超声诊断瘢痕妊娠的敏感性、特异性和准确性分别为82.5%、50.0%和79.5%。结论超声造影诊断瘢痕妊娠的准确性高于彩色多普勒超声,具有较好的临床应用价值。

Objective To compare the value of CEUS with CDFI for the diagnosis of CSP .Methods A total of 44 cases with gestational sac lying on the uterine isthmus underwent CEUS and CDFI to analysize the accuracy of the two methods in the diagnosis of CSP comparatively .Results Of the 44 cases , 40 cases were comfirmed CSP , 4 cases were comfirmed inevitable abortion , 39 cases were diagnosed CSP and one case were misdiagnosed by CEUS.CSP type showed as embryo sac and heterogeneous by CEUS .Type of embryo sac displayed donut sign which showed a rim -like homogeneous enhancement of the mass and the inside region without en -hancement .The heterogeneous type showed uneven enhancement .CSP were diagnosed by CEUS with a sensitivity of 97.5%, a speci-ficity of 75.0%and an accuracy of 95.3%., while CSP were diagnosed by CDFI with a sensitivity of 82.5%, a specificity of 50.0%and an accuracy of 79.5%.Conclusion CEUS has a higher accuracy for the diagnosis of CSP than CDFI and has a perfect clinical value.