阴道超声联合MRI对剖宫产后子宫切口瘢痕处妊娠的诊断价值

目的 分析阴道超声联合磁共振（MRI）检查对剖宫产后子宫切口瘢痕处妊娠（CSP）的诊断价值。方法 回顾性分析2014年1月至2018年3月安徽医科大学第二附属医院经手术及病理证实的72例剖宫产后子宫瘢痕妊娠患者的临床资料，72例患者均行阴道超声检查，且均在术前同时行MRI检查，将经阴道超声检查、MRI检查及阴道超声联合MRI检查的诊断结果与手术及病理的结果进行比较，比较3种检查方式的符合率及漏诊率。结果 72例患者中，经阴道超声正确诊断59例（81.94%），漏诊13例（18.06%）；MRI正确诊断66例（91.67%），漏诊6例（8.33%）；阴道超声联合磁共振正确诊断72例（100%）。MRI检查诊断CSP诊断率高于阴道超声检查，差异有统计学意义（P=0.01），联合诊断符合率高于MRI，且差异有统计学意义（χ²=6.26，P=0.012）。结论 阴道超声联合MRI检查可减少CSP病例漏诊率。

The clinical analysis forcesarean scar pregnancy with transvaginal ultrasound combined with MRI

Objective To analyse the diagnostic value of vaginal ultrasound combined with MRI for cesarean scar pregnancy. Methods Retrospective analysis was performed on the clinical data of 72 patients with uterine scar gestation after cesarean section confirmed by surgery and pathology from Jan 2014 to Mar 2018 in the Second Affiliated Hospital of Anhui Medical University. All the 72 patients underwent trans-vaginal ultrasound and MRI. The diagnostic results were compared with those of the operation and pathology of the single transvaginal ultrasonography, MRI examination and the combined MRI examination of vagina ultrasound, and the coincidence rate and the missed diagnosis rate were calculated. Results Of the 72 cases, 59 cases (81.94%) were correctly diagnosed by transvaginal ultrasound, but 13 cases missed (18.06%). 66 cases (91.67%) were correctly diagnosed by MRI, 6 cases missed (8.33%), and 72 cases (100%) correctly diagnosed by transvaginal ultrasound combined with MRI. For CSP, the diagnostic rate of MRI was higher than that of transvaginal ultrasonography. The difference was statistically significant (P=0.01), and the coincidence rate of combined diagnosis was higher. Conclusion The combination of transvaginal ultrasound and MRI examination can be used to reduce the rate of missed diagnosis.