经阴道彩色多普勒超声在诊断剖宫产子宫疤痕妊娠中的价值

Value of Transvaginal Color Doppler Ultrasound in Diagnosis of Cesarean Section Uterine Scar Pregnancy

目的:评估经阴道彩色多普勒超声在诊断剖宫产子宫疤痕妊娠中的价值。方法:选取本院收治的20例子宫疤痕妊娠患者作为样本,所有患者均首先采用经腹部超声诊断,后排空膀胱,采用经阴道彩色多普勒超声诊断。结果:采用经阴道彩色多普勒超声诊断剖宫产子宫疤痕妊娠,检出率为95%,与经腹部超声诊断对比,差异显著(P<0.05)。单纯孕囊型患者,宫腔内未见妊娠囊,宫颈回声无异常。子宫前壁下段宫颈口上方肌层连续性中断,凹陷变薄,可见妊娠囊,滋养层周边可见丰富血流信号。混合包块型患者,宫腔内未见妊娠囊,子宫前壁下段宫颈口至切口前壁肌层内见混合回声团块,回声不均匀,与肌层分界不清晰。部分位于宫腔型患者,宫腔内及瘢痕处,均见部分妊娠囊。结论:采用经阴道彩色多普勒超声诊断剖宫产子宫疤痕妊娠,能够提高检出率,且能够明确妊娠囊所处位置,鉴别子宫疤痕妊娠的类型,为临床制定处理方案提供指导。

Objective:To evaluate the value of transvaginal color Doppler ultrasound in the diagnosis of cesarean scar pregnancy.Methods:Twenty pregnant patients with uterine scar pregnancy were selected as samples.All patients were first diagnosed by transabdominal ultrasound,then the bladder was emptied,and transvaginal color Doppler ultrasound was used for diagnosis.Results:Transvaginal color Doppler ultrasound was used to diagnose cesarean scar pregnancy.The detection rate was 95%.Compared with transabdominal ultrasound diagnosis,the difference was significant(P<0.05).In patients with simple gestational sac type,there is no gestational sac in the uterine cavity,and there is no abnormality in cervical echo.The muscular layer above the cervical opening in the lower part of the anterior uterine wall is continuously interrupted,the depression becomes thinner,the gestational sac can be seen,and the rich blood flow signal can be seen around the trophoblast.In patients with mixed masses,no gestational sacs were seen in the uterine cavity,and mixed echo clumps were seen in the cervical layer from the anterior wall of the uterus to the anterior wall of the incision.Some are located in patients with uterine cavity type,and some gestational sacs are seen in the uterine cavity and scars.Conclusion:Transvaginal color Doppler ultrasound diagnosis of cesarean section uterine scar pregnancy can improve the detection rate,and clarify the location of the gestational sac,identify the type of uterine scar pregnancy,and provide guidance for the clinical development of treatment plans.