剖宫产瘢痕妊娠的MRI影像学表现与诊断价值

MRI imaging findings and diagnostic value of cesarean scar pregnancy

目的探讨剖宫产瘢痕妊娠的MRI影像学表现和诊断价值.方法收集我院2017年1月~2019年4月期间经手术病理证实为剖宫产瘢痕妊娠的患者27例,回顾性分析其MRI图像特征:其中15例行MRI增强扫描,12例行MRI平扫.观察剖宫产瘢痕妊娠的MRI表现、诊断准确率.结果 26例表现为子宫前壁峡部瘢痕处囊性或囊实性妊娠囊.瘢痕处肌层明显变薄.20例妊娠囊表现为囊性T1WI低T2WI高信号;6例表现囊实性,囊性信号内混杂T1WI稍低T2WI较高信号.15例增强扫描均见强化.1例未能确诊.结论剖宫产瘢痕妊娠的MRI影像学表现具有特征性,对其诊断和治疗具有重要价值.

Objective To investigate the MRI imaging findings and diagnostic value of cesarean scar pregnancy. Methods 27 patients with cesarean scar pregnancy who were confirmed by surgery and pathology in our hospital from January 2017 to April 2019 were collected. MRI image characteristic were retrospectively analyzed: 15 cases were given MRI enhanced scans, 12 cases were given MRI plain scan. The MRI findings and diagnostic accuracy of cesarean scar pregnancy were observed. Results 26 patients presented with cystic or solid-cystic gestational sacs at the isthmus of the anterior wall of the uterus. The muscle layer at the scar was significantly thinner. 20 cases of gestational sac showed cystic T1WI low T2WI high signal;6 cases showed solid-cystic nature, and the cystic signal was mixed with T1WI slightly lower T2WI higher signal. All 15 cases of enhanced scans were shown enhancement. One case was not diagnosed. Conclusion MRI imaging findings of cesarean scar pregnancy are characteristic and valuable for diagnosis and treatment.