超声联合3.0T磁共振对剖宫产后子宫憩室的诊断价值

Value of Ultrasound Combined with 3.0T MR in the Diagnosis of Cesarean Scar Diverticulum

目的分析超声联合3.0T磁共振对剖宫产后子宫憩室的诊断价值。方法选取医院2013年至2019年10月收治的疑似剖宫产后子宫憩室(CSD)患者40例,分别接受阴道超声、3.0T磁共振(MRI)检查后进行CSD术治疗。比较单纯阴道超声、MRI及联合诊断CSD阳性率、阴性率、获取CSD长度、深度、宽度、子宫肌层厚度及敏感度、特异度、阳性预测值及阴性预测值。结果经宫腔镜检查,40例患者中有36例患者为CSD,4例误诊。超声、MRI、联合诊断CSD阳性率、阴性率差异比较有统计学意义(P<0.05)。阳性率由高到低依次是联合诊断、MRI、超声。阴性率由高到低依次是超声、MRI、联合诊断。超声、MRI、联合诊断获取CSD长度、深度、宽度、子宫肌层厚度差异比较有统计学意义(P<0.05)。超声、MRI、联合诊断敏感度、特异度差异比较有统计学意义(P<0.05)。敏感度、特异度、阳性预测值、阴性预测值由高到低依次是联合诊断、MRI、超声。结论阴道超声联合3.0T磁共振能明显提升剖宫产后子宫憩室诊断价值,同时能获取较准确的CSD深度及宽度,推荐使用。

Objective To investigate the value of ultrasound combined with 3.0T MR in the diagnosis of cesarean scar diverticulum(CsD).Methods 40 patients with suspected CsD in our hospital from January 2013 to October 2019 were enrolled,and received transvaginal ultrasound and 3.0T magnetic resonance(MRI)respectively.Then the positive rate,negative rate,length,depth,width,myometrium thickness,cause-positive rate,sensitivity,specificity,positive predictive value and negative predictive value of CsD diagnosed by vaginal ultrasound,MRI and combined examination were compared.Results 36 of 40 patients were CsD by hysteroscopy diagnosis and 4 were misdiagnosed.The positive and negative rates of CsD showed significant difference among ultrasound,MRI and combined examination(P<0.05).The positive rate was highest in the combined diagnosis,followed by MRI and ultrasound.The negative rate was the highest in the ultrasound,followed by MRI and combined diagnosis.The length,depth,width and myometrium thickness of CsD obtained by ultrasound,MRI and combined diagnosis were significantly different(P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of CsD diagnosed by three methods was significantly different(P>0.05),which was the highest in the combined diagnosis,followed by MRI and ultrasound.Conclusion Application of transvaginal ultrasound combined with 3.0T MRI can significantly improve the diagnostic value of CsD,and obtain more accurate depth and width of CsD,which is recommended.