超声与磁共振检查诊断瘢痕妊娠的对比研究

Comparative study on diagnosis of scar pregnancy by color ultrasound and magnetic resonance imaging

目的探讨超声与磁共振检查诊断剖宫产术后子宫瘢痕妊娠(CSP)患者的临床价值。方法选取2013年8月至2018年2月在福建省龙海市第一医院收治的临床初步诊断为CSP患者56例,观察超声与磁共振的检查结果,以病理结果为金标准,比较2种诊断方法的诊断效能和显示孕囊位置、体积、性质、子宫肌层的浸润、是否合并囊内及宫腔出血、卵黄囊及原始心管搏动等情况。结果超声与磁共振检查诊断CSP的准确率均较高,差异无统计学意义(P>0.05);超声显示卵黄囊、胚芽和原始心管搏动优于磁共振检查;磁共振检查显示囊内出血、囊性孕囊的子宫腔内积血以及包块型孕囊对子宫肌层浸润优于超声检查,差异具有统计学意义(P<0.05)。结论超声与磁共振检查均是诊断CSP的有效方法,但两者征象侧重有所不同。

Objective To investigate the clinical value of color ultrasound and MRI in diagnosing uterine scar pregnancy after caesarean section. Methods Fifty-six cases with uterine scar pregnancy after caesarean section of clinical preliminary diagnosis in the first hospital of Ionghai city, from August 2013 to February 2018 was selected. To observe the results of color ultrasonography and MRI, to compare the diagnostic efficacy of the two diagnostic methods with the pathological results, and to show the location, volume, nature, invasion of uterine muscle layer, whether intra- cystic and intrauterine hemorrhage, display of yellow sac and beating of primary heart tube.Results The accuracy of color ultrasound and MRI for the diagnosis of CSP was higher, and there was no significant difference（P〉0.05）. Color ultrasonography showed that the follicle, germ and primitive heart tube beat better than MRI. MRI showed that intra- cystic hemorrhage, intrauterine hematocele and lumen pregnancy sac were significantly better than color ultrasound（P〈 0.05）. Conclusion Both color ultrasound and MRI are effective methods for diagnosis of CSP, but the two signs are different.