磁共振多序列成像在早期瘢痕妊娠中的应用价值研究

Application value of magnetic resonance multiple sequence imaging in early cesarean scar pregnancy

目的探讨磁共振多序列成像在早期瘢痕妊娠(CSP)诊断与鉴别中的应用价值。方法回顾性分析2020年1月至2022年1月新余市人民医院收治的60例疑似剖宫产手术后宫腔内瘢痕处早期妊娠的的患者资料,所有患者均接受磁共振成像(MRI)扫描检查与临床手术及病理检查。以临床手术及病理检查结果为金标准,分析60例疑似病例的诊断结果、CSP不同分型孕囊MRI影像学特征、CSP患者MRI分级结果等。结果60例疑似病例经由临床手术及病理检查确诊CSP者55例,MRI检查诊断为CSP者54例,MRI对CSP的诊断符合率为96.67%,特异度为80.00%,灵敏度为98.18%;MRI确诊的54例CSP患者分型:内生型19例,外生型35例,其中内生型CSP患者瘢痕厚度大于外生型,孕囊面积小于外生型,孕囊与瘢痕组织相交距离短于外生型,差异有统计学意义(P<0.05);MRI确诊的54例CSP患者MRI分级:0级5例,1级15例,2级23例,3级11例。结论磁共振多序列成像应用于早期瘢痕妊娠患者中的诊断效能突出,能有效明确CSP分型与分级,为疾病的诊断、治疗或管理方案的制定提供切实依据。

Objective To explore the application value of magnetic resonance multi-sequence imaging in the diagnosis and identification of early cesarean scar pregnancy(CSP).Methods The data of 60 patients with suspected early pregnancy in intrauterine scar after cesarean section who were admitted to Xinyu People's Hospital from January 2020 to January 2022 were retrospectively analyzed,all patients underwent magnetic resonance imaging(MRI)and clinical and pathological examinations.With the results of clinical surgery and pathological examination as the gold standard,the diagnostic results of 60 suspected cases,the MRI imaging characteristics of gestational sacs with different CSP types,and the MRI grading results of CSP patients were evaluated and analyzed.Results Of 60 suspected cases,55 cases were diagnosed as CSP by clinical operation and pathological examination,and 54 cases were diagnosed as CSP by MRI examination,the diagnostic coincidence rate of MRI in the diagnosis of CSP was 96.67%,the specificity was 80.00%,and the sensitivity was 98.18%.Among the 54 CSP patients diagnosed by MRI,19 cases were endogenous type and 35 cases were exogenous type,and the scar thickness in theendogenous CSP patients was larger than that in the exogenous type,the area of gestational sac was smaller than that in the exogenous type,and the intersection distance between gestational sac and scar tissue was shorter than that in the exog-enous type,and the differences were statistically significant(P<0.05).Among the 54 CSP patients diagnosed by MRI,5 cases were grade 0,15 cases were grade 1,23 cases were grade 2,and 11 cases were grade 3.Conclusion Magnetic resonance multi-sequence imaging has outstanding diagnos-tic performance in patients with early scar pregnancy,which can effectively clarify the CSP classification and grading,and provide a practical basis for the diagnosis,treatment or management of the disease.