经阴道彩色多普勒超声联合MRI诊断剖宫产术后瘢痕妊娠的价值分析(1)
[摘要] 目的 探讨剖宫产术后瘢痕妊娠实施经阴道彩色多普勒超声联合MRI诊断的价值。 方法 择取我院2017年1月～2018年10月收治的36例剖宫产术后瘢痕妊娠患者，对所有患者进行经阴道彩色多普勒超声检查和MRI检查，比较两种方式单独检查和联合检查的效果。 结果 实施MRI检查对剖宫产术后瘢痕妊娠的总检出率(94.4%)高于经阴道彩色多普勒超声检查(77.8%)(P<0.05);实施经阴道彩色多普勒超声检查和MRI检查联合时对剖宫产术后瘢痕妊娠的总检出率(100.0%)高于经阴道彩色多普勒超声单独检查(77.8%)(P<0.05);实施经阴道彩色多普勒超声检查和MRI联合诊断检查时对剖宫产术后瘢痕妊娠的总检出率(100.0%)高于MRI单独检查(94.4%)(P<0.05)。 结论 剖宫产术后瘢痕妊娠实施MRI诊断效果优于经阴道彩色多普勒超声检查，且实施经阴道彩色多普勒超声联合MRI诊断的效果更好，可进一步降低漏诊风险。
[关键词] 剖宫产;瘢痕妊娠;经阴道彩色多普勒超声;MRI
[中图分类号] R445 [文献标识码] B [文章编号] 1673-9701(2019)12-0116-04
Value of transvaginal color Doppler ultrasound combined with mri in the diagnosis of scar pregnancy after cesarean section
ZHANG Jianhong
Department of Ultrasound，the Third People's Hospital of Huizhou City in Guangdong Province，Huizhou 516002，China
[Abstract] Objective To explore the value of transvaginal color Doppler ultrasound combined with MRI in the diagnosis of scar pregnancy after cesarean section. Methods 36 patients with scar pregnancy after cesarean section treated in our hospital from January 2017 to October 2018 were selected and all the patients were given transvaginal color Doppler ultrasound combined with MRI. The effects of the two examine methods were compared. Results The total detection rate of scar pregnancy after cesarean section was 94.4% by MRI， which was higher than that of transvaginal color Doppler ultrasonography(77.8%)(P<0.05). The total detection rate of scar pregnancy after cesarean section by transvaginal color Doppler ultrasonography combined with MRI was 100.0%， which was higher than that of transvaginal color Doppler ultrasound alone(77.8%)(P<0.05)， and higher than that of MRI alone(94.4%)(P<0.05). Conclusion The diagnostic effect of MRI of scar pregnancy after cesarean section is better than that of transvaginal color Doppler ultrasonography， and the combination of the two methods is more effective， which can further reduce the risk of missed diagnosis.
[Key words] Cesarean section; Scar pregnancy; Transvaginal color Doppler ultrasound; MRI
随着我国二胎政策放开，剖宫产术后瘢痕妊娠的发生率也逐渐升高，而剖宫产术后瘢痕妊娠属于较为特殊的异位妊娠类型，同时也是导致母婴不良结局的重要因素，及早发现剖宫产术后瘢痕妊娠，并及早终止妊娠，以保证孕妇生命安全是目前处理剖宫产术后瘢痕妊娠的主要原则[1-2]。剖宫产术后瘢痕妊娠患者临床早期表现缺乏特异性，以腹痛、阴道不规则流血为主要表现，难以诊断。目前影像学技术在产科检查中运用较多，其中超声检查的运用最为广泛，但单一超声检查诊断时也存在漏诊情况。MRI检查可获得检查部位立体图像，使图像空间分辨率更高，MRI检查在产科检查中也逐渐作为超声检查的补充。为明确超声检查和MRI檢查联合在剖宫产术后瘢痕妊娠中的运用效果，本研究对我院经临床及病理证实的36例剖宫产术后瘢痕妊娠患者实施了经阴道彩色多普勒超声检查和MRI检查，现报道如下。, http://www.100md.com(张建红)
[关键词] 剖宫产;瘢痕妊娠;经阴道彩色多普勒超声;MRI
[中图分类号] R445 [文献标识码] B [文章编号] 1673-9701(2019)12-0116-04
Value of transvaginal color Doppler ultrasound combined with mri in the diagnosis of scar pregnancy after cesarean section
ZHANG Jianhong
Department of Ultrasound，the Third People's Hospital of Huizhou City in Guangdong Province，Huizhou 516002，China
[Abstract] Objective To explore the value of transvaginal color Doppler ultrasound combined with MRI in the diagnosis of scar pregnancy after cesarean section. Methods 36 patients with scar pregnancy after cesarean section treated in our hospital from January 2017 to October 2018 were selected and all the patients were given transvaginal color Doppler ultrasound combined with MRI. The effects of the two examine methods were compared. Results The total detection rate of scar pregnancy after cesarean section was 94.4% by MRI， which was higher than that of transvaginal color Doppler ultrasonography(77.8%)(P<0.05). The total detection rate of scar pregnancy after cesarean section by transvaginal color Doppler ultrasonography combined with MRI was 100.0%， which was higher than that of transvaginal color Doppler ultrasound alone(77.8%)(P<0.05)， and higher than that of MRI alone(94.4%)(P<0.05). Conclusion The diagnostic effect of MRI of scar pregnancy after cesarean section is better than that of transvaginal color Doppler ultrasonography， and the combination of the two methods is more effective， which can further reduce the risk of missed diagnosis.
[Key words] Cesarean section; Scar pregnancy; Transvaginal color Doppler ultrasound; MRI
随着我国二胎政策放开，剖宫产术后瘢痕妊娠的发生率也逐渐升高，而剖宫产术后瘢痕妊娠属于较为特殊的异位妊娠类型，同时也是导致母婴不良结局的重要因素，及早发现剖宫产术后瘢痕妊娠，并及早终止妊娠，以保证孕妇生命安全是目前处理剖宫产术后瘢痕妊娠的主要原则[1-2]。剖宫产术后瘢痕妊娠患者临床早期表现缺乏特异性，以腹痛、阴道不规则流血为主要表现，难以诊断。目前影像学技术在产科检查中运用较多，其中超声检查的运用最为广泛，但单一超声检查诊断时也存在漏诊情况。MRI检查可获得检查部位立体图像，使图像空间分辨率更高，MRI检查在产科检查中也逐渐作为超声检查的补充。为明确超声检查和MRI檢查联合在剖宫产术后瘢痕妊娠中的运用效果，本研究对我院经临床及病理证实的36例剖宫产术后瘢痕妊娠患者实施了经阴道彩色多普勒超声检查和MRI检查，现报道如下。, http://www.100md.com(张建红)