三维超声与MRI在剖宫产术后子宫瘢痕妊娠早期诊断中的应用

Application of Three-dimensional Ultrasound and MRI in Early Diagnosis of Cesarean Scar Pregnancy

目的探究三维超声与磁共振成像(MRI)在剖宫产术后子宫瘢痕妊娠早期诊断中的应用价值。方法回顾性分析2018年6月至2020年6月医院收治的89例有剖宫产术史妊娠妇女临床诊治资料和影像学资料,依据检查方法不同分为超声组(n=45,采用三维超声检查)和MRI组(n=44,采用MRI扫描检查)。比较两组诊断剖宫产术后子宫瘢痕妊娠与病理结果的一致性及灵敏度、特异度、准确度,对比两组影像学征象检出率。结果超.声组和MRI组一般资料比较差异无统计学意义(P>005);三维超声诊断剖宫产.术后子宫瘢.痕妊娠的.灵敏度、特异度、准确度为9375%、8462%、9111%;MRI诊断剖宫产.术后子宫瘢.痕妊娠的.灵敏度、特异度、准确度为9655%、8667%、9.333%,两组诊断效能比较差异无统计学意义(P>.005);超声组诊断出结果时间明显短于MRI组(P<005)。MRI组孕囊内出血、宫腔积血、局部瘢痕浸润检出率较超声组明显高,而卵黄囊、.胚芽、原始心管搏动检出率则明显低于超声组(P<005)。结论三维超声与MRI在剖宫产术后子宫瘢痕妊娠早期诊断中均有较高价值,三维超声检测方便快速,但MRI在显示妊娠囊内出血、宫腔积血、局部瘢痕浸润等方面相较三维超声更占优势。

Objective To explore the application value of three-dimensional ultrasound and magnetic resonance imaging(MRI) in early diagnosis of cesarean scar pregnancy. Methods The clinical diagnosis and treatment data and imaging data of 89 women who underwent cesarean section in the hospital between June 2018 and June 2020 were retrospectively analyzed. According to the examination method, they were divided into ultrasound group(n=45, three-dimensional ultrasound examination) and MRI group(n=44, MRI scanning). The consistencies of the two methods and pathological results, sensitivities, specificities and accuracy rates in diagnosis of cesarean scar pregnancy were compared. The detection rates of imaging signs were also compared between the two groups. Results There were no significant differences in general data between ultrasound group and MRI group(P>0.05). The sensitivity, specificity and accuracy of three-dimensional ultrasound in diagnosis of cesarean scar pregnancy were 93.75%, 84.62% and 91.11%, which of MRI were 96.55%, 86.67% and 93.33%, showing no significant difference in diagnostic efficiency between the two groups(P>0.05). The diagnosis time of ultrasound group was significantly shorter than that of MRI group(P<0.05).The detection rates of hemorrhage inside the gestational sac, hematocele in uterine cavity and local scar infiltration in MRI group were significantly higher than those in ultrasound group, while the detection rates of yolk sac, germ and primitive heart tube beat were significantly lower than ultrasound group(P<0.05). Conclusion Both three-dimensional ultrasound and MRI are of high value in early diagnosis of cesarean scar pregnancy. Three-dimensional ultrasonic testing is convenient and fast. However, MRI has more advantages over three-dimensional ultrasound in displaying hemorrhage in the gestational sac, hematocele in uterine cavity and local scar infiltration.