对比分析瘢痕妊娠不同分型患者经阴道超声特征及其临床特点

Comparative analysis of transvaginal ultrasound characteristics and clinical characteristics in patients with different types of cesarean scar pregnancy

目的:探讨瘢痕妊娠(CSP)不同分型患者经阴道超声特征及其临床特点。方法:选取2021年1月—2023年9月金乡县人民医院收治的CSP患者72例,均需经阴道超声检查,以组织病理学检查结果为金标准,分析经阴道超声对不同分型CSP的诊断符合率及其超声声像学特征。结果:以组织病理学检查结果为金标准,经阴道超声对瘢痕妊娠的诊断符合率为90.28%。孕囊型CSP瘢痕处回声孕囊样结构、瘢痕处不均匀混合回声、病灶丰富血供比例均低于团块型CSP,子宫下段病灶最大径小于团块型CSP,瘢痕处剩余肌层厚度大于团块型CSP(P <0.05);两种类型CSP子宫位置、盆腔积液及宫底部内膜厚度比较差异无统计学意义(P> 0.05)。结论:经阴道超声能提高CSP患者的诊断符合率,且不同分型CSP患者具有典型的超声特征,有助于为正确诊断CSP提供参考依据。

Objective To explore the characteristics and clinical characteristics of transvaginal ultrasound in patients with different types of cesarean scar pregnancy(CSP).Methods A total of 72 patients with CSP admitted to our hospital from January 2021 to September 2023 were selected to undergo transvaginal ultrasonography.Histopathology results were used as the gold standard to analyze the diagnostic coincidence rate and ultrasonographic characteristics of different types of CSP by transvaginal ultrasonography.Results The histopathological results were taken as the gold standard.the diagnostic coincidence rate of transvaginal ultrasound for scar pregnancy was 90.28%.The echogenicity of gestational sac type CSP was lower than that of agglomerate type CSP,including gestational sac like structure,uneven mixed echo at scar site,and richer blood supply ratio of lesions,the maximum diameter of lesions in the lower uterine segment was smaller than that of agglomerate type CSP,and the remaining muscle thickness was greater than that in the CSP group(P<0.05).There was no statistically significant difference in the position of the uterus,pelvic fluid accumulation,and endometrial thickness at the bottom of the uterus between the two types of CSP(P>0.05).Conclusion Transvaginal ultrasound can improve the diagnostic coincidence rate of CSP patients,and different types of CSP patients have typical ultrasonic characteristics,which is helpful to provide reference for correct diagnosis of CSP.