剖宫产术后子宫瘢痕妊娠的声像图特征和鉴别诊断分析

The Analysis of Sonographic Features and Diagnosis of Cesarean Scar Pregnancy

目的:探讨剖宫产术后瘢痕妊娠超声检查的声像图特征以及误诊原因,以提高对此病的超声诊断正确率。材料与方法:回顾性分析我院35例疑似剖宫产术后瘢痕妊娠病例的临床资料(其中手术证实26例,误诊9例),探讨其声像图特征,分析误诊原因。结果:26例剖宫产术后瘢痕妊娠超声图像主要表现为子宫下段剖宫产切口部位可见孕囊或者不均质包块,其与膀胱之间的子宫肌层变薄或不连续,其内及周边血运较丰富。9例误诊病例中,以宫颈妊娠最多。诊断符合率为74%。结论:剖宫产术后瘢痕妊娠的超声图像比较有特异性,超声对其有一定的诊断价值,需与宫颈妊娠、不全流产等进行鉴别,应注意结合病史并观察前壁肌层是否变薄或消失,内部及周边是否有血流供应以资鉴别。

Purpose： To the sonographic features and misdiagnosis reasons of cesarean scar pregnancy,improve the diagnostic accuracy of the disease. Materials and Methods： Retrospective analysis clinical data of 35 Suspected cases of cesarean scar pregnancy,among which 26 were Operation confirmed,9 misdiagnosis. Investigate their sonographic features and misdiagnosis reasons. Results： 26 cases of cesarean section scar pregnancy ultrasound image is mainly manifested visible Gestational sac or heterogeneous mass in the lower part of the Incision site of lower uterine segment cesarean section. The uterine muscular layer between bladders is thin or discontinuous. The blood circulation is abundant in the inner and periphery. The 9misdiagnosis cases were mostly cervical pregnancy. The diagnostic accordance rate was 74%. Conclusion： The ultrasound images of scar pregnancy after cesarean section were comparatively Specific,which has a certain diagnostic value,but it should be distinguished with cervical pregnancy,incomplete abortion,and consider the medical history,observe whether the Anterior wall of uterus is thin or disappear,whether there＇s blood circulation in the inner and periphery,for identification.