3.0 T高场强磁共振增强扫描在早期瘢痕妊娠中的应用价值

Application value of 3.0 T high-field enhanced magnetic resonance scan in early scar pregnancy

目的探讨3.0 T高场强磁共振(MR)增强扫描在早期瘢痕妊娠中的应用价值。方法回顾性分析上饶市人民医院2019年1~12月收治的62例阴道异常出血患者,均分别实施3.0 T高场强MR盆腔平扫、3.0 T高场强MR盆腔平扫+增强扫描,分析MRI影像结果并比较两种方法的早期瘢痕妊娠诊断结果及灵敏性、特异性、准确性。结果经手术证实,早期瘢痕子宫妊娠患者50例,剖宫产瘢痕均位于子宫前壁峡部,43例表现为单纯均匀T1WI低信号及T2W2I高信号,7例表现出不规则T2WI信号,增强扫描后表现为完整环形强化或不完整边缘明显强化。行MR盆腔平扫后,诊断为早期瘢痕妊娠41例,漏诊9例,误诊6例;行MR盆腔平扫+增强扫描后,诊断为早期瘢痕妊娠48例,漏诊2例,误诊1例。MR盆腔平扫用于早期瘢痕妊娠诊断的灵敏性、特异性、准确性分别为82.00%、50.00%、82.14%,均低于MR盆腔平扫+增强扫描的96.00%、91.67%、95.24%,差异有统计学意义(P<0.05)。结论3.0 T高场强MR增强扫描在早期瘢痕妊娠中具有较高的应用价值,平扫可有效显示妊娠囊同瘢痕的位置关系,而增强扫描对内容物及瘢痕厚度的显示效果更佳,可作为平扫的有效补充,指导临床治疗。

Objective To investigate the application value of 3.0 T high-field enhanced magnetic resonance(MR)scan in early scar pregnancy.Methods The clinical data of 62 patients with abnormal vaginal bleeding admitted to Shangrao People′s Hospital from January to December 2019 were retrospectively analyzed.3.0 T high-field magnetic resonance pelvic plain scan and 3.0 T high-field magnetic resonance pelvic plain scan+enhanced scan were performed respectively.The magnetic resonance imaging results were analyzed and the sensitivity,specificity and accuracy of the two methods were compared.Results A total of 50 cases of uterine pregnancy with early scarring were confirmed by surgery.Cesarean section scars were all located in the isthmus of the anterior wall of the uterus.A total of 43 cases showed simple and uniform T1WI low signal and T2W2I high signal,7 cases showed irregular T2WI signal,after contrast-enhanced scanning,which showed complete circular enhancement or incomplete edge enhancement.A total of 41 cases of early scar pregnancy were diagnosed after magnetic resonance pelvic plain scan,9 cases were missed,and 6 cases were misdiagnosed.After magnetic resonance pelvic plain scan+enhanced scan,48 cases were diagnosed early scar pregnancy,2 cases were missed,and 1 case was misdiagnosed.The sensitivity,specificity and accuracy of MR pelvic scan for early scar pregnancy diagnosis were 82.00%,50.00%,and 82.14%,which were lower than those of MR pelvic scan+enhanced scan(96.00%,91.67%,95.24%),the differences were statistically significant(P<0.05).Conclusion 3.0 T high-field intensive MR enhanced scan has a high application value in early scar pregnancy.Plain scan can be effective and show the relationship between the pregnancy sac and the scar position,while the enhanced scan has a better display effect on the content and scar thickness,which can be used as an effective supplement of plain scan and guide clinical treatment.