经阴道超声诊断子宫切口瘢痕妊娠的影响因素分析

The influencing factor of transvaginal ultrasonography in the diagnosis of cesarean scar pregnancy

目的：对经阴道超声（TVS）诊断子宫下段剖宫产切口瘢痕妊娠（CSP）进行总结分析,探讨如何提高TVS诊断CSP的准确率和及时性。方法：回顾性分析32例临床确诊为CSP患者的TVS声像图,分析影响TVS诊断准确率的因素。结果：TVS诊断CSP的准确率84.4%（27/32）。其中诊断不均质包块型CSP准确率100.0%（12/12）,单纯孕囊型CSP 75.0%（15/20）。结论：提高TVS诊断CSP准确率的关键是提高诊断单纯孕囊型CSP的准确率,影响单纯孕囊型CSP诊断的因素主要包括孕囊与子宫切口瘢痕距离（距离2.5-7.0 mm的超声表现也应引起重视）和对CSP超声图像的熟悉程度。

Objective：To analyze the value of transvaginal ultrasound（TVS） in the diagnosis of cesarean scar pregnancy （CSP）, and improve the accuracy and timeliness of TVS diagnosis. Methods ： The TVS images of CSP in 32 patients were retrospectively analyzed, the influencing factors of the diagnosis accuracy rate of TVS were analyzed. Results ： The accuracy rate of TVS in the diagnosis of CSP was 84.4% （ 27/32 ） , the diagnostic accuracy rate of TVS in heterogeneous mass type and simple gestational sac type CSP were 100.0% （ 12/12 ） and 75.0% （ 15/20 ） , respectively. Conclusions ： Improving the TVS accuracy in the diagnosis of simple gestational sac type CSP is the key of improving the TVS accuracy in diagnosing CSP. The distance between gestational sac and uterine incision scar and knowledge of CSP ultrasound images are the main influencing factors of the diagnosis of simple gestational sac type CSP.