经阴道二维和三维超声对剖宫产术后子宫疤痕部位妊娠的诊断价值

Value of transvaginal two-dimensional and three-dimensional ultrasound in diagnosis of scar pregnancy after uterine cesarean section

目的评价经阴道二维、三维超声在诊断剖宫产术后子宫疤痕部位妊娠(简称切口妊娠)的价值。方法回顾分析2015-2016年经阴道二维超声诊断为子宫前壁下段剖宫产切口妊娠的病例30例,在此基础上进行阴道三维超声诊断,所有病例均行磁共振检查核实。分析阴道二维、三维超声诊断为切口妊娠的价值。结果有1例经阴道二维超声诊断为切口处及宫腔下段孕囊部分植入型,后经阴道三维超声诊断为切口处孕囊完全植入型,其余分型与三维超声诊断一致。磁共振检查结果与阴道三维超声一致。三者诊断分型符合率比较差异无统计学意义(P>0.05)。结论阴道三维超声可更为直观地显示病灶位置、范围、切口受累情况,较经阴道二维超声具有更加丰富的诊断信息。

Objective To evaluate the value of transvaginal two-dimensional and three-dimensional ultrasound in diagnosis of cesarean scar pregnancy（incision area pregnancy）after cesarean section.Methods Thirty cases of cesarean incision pregnancy at lower section of uterine anterior wall diagnosed by transvaginal two-dimensional ultrasound during 2015-2016 were retrospectively analyzed.On this basis,all cases conducted transvaginal three-dimensional ultrasound and were verified by magnetic resonance（MR）examination.Then the values of transvaginal two-dimensional and three-dimensional ultrasound in diagnosis of incision area pregnancy were analyzed.Results One case was diagnosed as the incision site and partial implantation of pregnant capsule by transvaginal two-dimensional ultrasound,and then diagnosed as the complete implantation of pregnant capsule at incision site,the other types were consistent to the diagnosis by the three-dimensional ultrasound.The MR examination results were consistent to the those by three-dimensional ultrasound.The diagnosis typing coincidence rate had no statistical difference among the three methods（P0.05）.Conclusion Transvaginal three-dimensional can more intuitively display the lesion′s position,range,incision involvement situation,while transvaginal two-dimensional ultrasound has more plentiful diagnostic information.