超声造影在剖宫产术后孕囊型瘢痕妊娠早期诊断中的应用研究

Application of contrast-enhanced ultrasound in early diagnosis of gestational sacs type cesarean scar pregnancy

目的探讨超声造影在孕囊型剖宫产术后瘢痕妊娠(CSP)早期诊断中的应用价值。方法回顾性分析38例剖宫产术后常规彩超检查怀疑孕囊型CSP的患者的超声造影资料,分析孕囊型CSP的彩超及超声造影特点,并评价经腹彩超、经阴道彩超、超声造影3种方法的诊断符合率。结果孕囊型CSP在超声造影中表现为病灶与子宫肌层同步增强,呈环形强化,并可在增强早期显示病灶的血供来自于瘢痕处。超声造影检查与手术确诊比较,超声造影的诊断符合率达到100.0%,显著高于经腹彩超(72.7%)及经阴道彩超方法(87.5%)(P<0.05)。结论超声造影可明确显示孕囊型CSP病灶的血供情况,能显著提高孕囊型CSP的诊断率,并为临床上治疗方案的确定提供了一定依据。

Objective： To investigate the value of contrast-enhanced ultrasound in the early diagnosis of gestational sacs type cesarean scar pregnancy（CSP）.Methods： The data of contrast-enhanced ultrasound in 38 patients who were suspected gestational sacs type CSP by routine color ultrasonography examination were retrospectively analyzed.The characteristics of gestational sacs type CSP examined by ultrasonography and contrast-enhanced ultrasound were explored,and the coincidence rate of the three methods,i.e.abdominal color ultrasound,transvaginal color ultrasound,and contrast-enhanced ultrasound diagnosis were evaluated.Results： The contrast-enhanced ultrasound examination of gestational sacs type CSP showed synchronous lesions and myometrium enhanced,presented a ring enhancement,and the blood supply was from the scar in the early enhancement.The diagnosis coincidence rate of CSP by contrast-enhanced ultrasound was 100% confirmed by the surgical results,which was significantly higher than abdominal color ultrasound（72.7%）and transvaginal color ultrasound（87.5%）（P〈0.05）.Conclusions： Contrast-enhanced ultrasound can clearly show the blood supply situation of gestational sacs type CSP,and increase its diagnosis rate and provide basic evidence for clinical therapeutic schedule.